Thank you for providing contact information to Janice R. Harper,
the VP of the Memphis Dental Assistants Society.
Your information will be used to construct a data base
for the purpose of promoting dental assistant education and activities in our area
.  We respect your privacy.
Please tell us about you
* Required Field
*E-mail Address:
* Your Name
* Street Address  
 Apt No.
* City
 * State
 * Zip Code
Home Telephone:
Work Telephone:
Company or DDS/Employer Name:
* Job Title
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Not a member?  Please tell us why.
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Memphis
Dental
Assistants'
               Society