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Review and print the form below. Then, return to the task page for further instruction.


Step 1: Review the document below and check for any errors relating to your practice name or information. If there are any errors, contact your Practice Development Manager.

Step 3: Click print form to print copies of the agreement.

Step 3: Return to the previous task page for further instructions.


» print form


IMPORTANT NOTICE - CHANGE OF BILLING INFORMATION


IMPORTANT NOTICE
Change of Billing Information

Old Account Information

Account Number:  
Address:   , , , , 
Phone:  
Contact Name:  
Email:  

Dear, Vendor -

Account taken over with effect from:
New Account “Bill to” Name:

Please be advised that the above Dental Practice’s technical health care services business has been acquired by (“Dental Corporation”) as per date indicated above. The ordering of all goods and services will be done by Dental Corporation operating from the existing practice location.

Delivery

All deliveries and invoices should continue to be sent directly to the Dental Practice address.

Change of Name

It is crucial that the account details are amended to reflect the new corporate name, , and that all future invoices reflect the new business name “”. Additionally, a new Account Number will be required.

Payment

Dental Corporation will be coordinating payment of all authorized invoices via Electronic Funds Transfer (EFT). If your company is not currently doing business (or not receiving electronic payments) with Dental Corporation, please complete the attached form and forward via email to accountspayable@dentalcorp.ca. All queries regarding payment should be directed to dentalcorp Accounts Payable at the same email address, and not to the Practice.

Questions

If you have any queries regarding the above, or any other matter, please do not hesitate to contact the Accounts Payable Team at our Support Centre by calling 416.558.8338 or via email at accountspayable@dentalcorp.ca.


Sincerely,

_______________________________

Practice Partner

_______________________________

Practice Partner Signature


IMPORTANT NOTICE - CHANGE OF BILLING INFORMATION



Form to be completed by the Vendor and returned to:

DENTAL CORPORATION OF CANADA INC. - ACCOUNTS PAYABLE TEAM
Suite 1420 – 21 St. Clair Avenue East, Toronto, ON M4T 1L9
TEL: 416.558.8338 | FAX: 647.347.7925

Please DO NOT send INVOICES to the address above.  All invoices should be sent to the practice directly.


Practice Details:

Practice Name:  
New Account Number: 

New Vendor Details:

Company Name: 
Postal Address: 
Delivery Address: 
Phone Number: 
Fax Number: 
Accounts Receivable Contact: 
Email Address*: 

IMPORTANT: Banking Details for Electronic Transfer purposes only

Account Name: 
Bank Name: 
Branch Address: 
Transit #: 
Institution #: 
Account #: 
Payment Terms: 



PLEASE ATTACH VOIDED CHEQUE TO ENSURE ACCURACY OF YOUR PAYMENT