Become a DENTSPLY Alliance member today


There are two simple ways for you to become a member of DENTSPLY Alliance.


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Application Forms

Please return the ADA Platinum Credit Card application and/or the ADA Platinum Business Credit Card application to the
American Express Business Card Team: American Express House, 12 Shelley Street, Sydney NSW 2000.

Simply complete and return your DENTSPLY Alliance application to DENTSPLY, or alternatively give your Alliance application form
to your DENTSPLY Sales Professional. For further information please contact DENTSPLY on 1300 55 29 29.


The Alliance enrolment form

The ADA Platinum Credit Cardmember form

The ADA Platinum Business Credit Cardmember form

DENTSPLY Automatic Deduction Account Payment Option


Great news you now have the option to pay your DENTSPLY account automatically using your American Express Credit Card.
Simply complete the application form below and fax ((03) 9538 8250) or post it (PO Box 1111, Mt Waverley VIC 3149) to DENTSPLY.

Automatic Deduction Payment application form


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