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Repair Order Form

Repair Form NEW

Contact Info

First
Last
Address
Address
City
State/Province
Zip/Postal

Dealer Info

Enter "Call Dealer For PO#" if you do not have one.

Product Info

You can enter more than 1 product

0 of 255 max characters
Did the issue occur during use on a patient?
Was the patient injured?
plus1 Add Another Product minus1 Remove Product

Upon submission, your form will be emailed to our Air Repair Department. They will email you an RMA# and shipping label to use for the repair. Please note that this form is only for warranty and paid repairs. For repair estimates, please refer to our price list or call 800-800-7202.

  • All dental handpieces must be heat sterilized before sending in for repair.
  • Please do not leave any burs or needles in your handpiece, attachment, or syringe as it will not be returned back to you upon completion of the repair.
  • All orders will be billed through an authorized DENTSPLY distributor.

Customer Service

Any Questions?

800-800-7202

DENTSPLY SIRONA US REPAIR CENTER
ATTN: MIDWEST AIR REPAIR
1301 Smile Way
York, PA 17404 USA