AID RegistrationFirst Name *Last Name *Age *Sex *MaleFemaleOtherYear Of Graduation *Year Of Post Graduation DCI Registration No. *Name of Dental College *Practice Name Practice Address *State/UT *OdishaBiharUttar PradeshKeralaMaharashtraTamil NaduPunjabKarnatakaRajasthanGujaratJammuKashmirTelenganaWest BengalAndhra PradeshHaryanaMadhya PradeshJharkhandAssamGoaHimachal PradeshArunachal PradeshManipurSikkimNagalandChhatisgarhUttarakhandTripuraMeghalayaMizoramDelhiDaman & DiuLakshadweepAndaman & NicobarDadra & Nagar HaveliPuducherryChandigarhCity *Pincode *Mobile *WhatsApp *Email ID *Landline Number Area of Specialization *OrthodonticsProsthodontics EndodonticsPeriodonticsOral & Maxillofacial SurgeryOral Medicine & RadiologyCommunity DentistryPaedodonticsImplantologyGeneral DentistryPhone Are you practicing Implant Dentistry YesNo Years of Implant practice How many Implants do you use per year? Yet to Start<2020-5050-100Can you provide on-site support to the new Implant practitioners in your city? YesNoWhat would be the fees for providing on-site support?
