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Register for KADA + KAOMI 2022
Step1: Registration
Name
Gender
Male
Female
Dental License No.
Email
Phone
Practice Address
Practice Type
Private
Corporate / Large Group Practice
Community Health
Academia / Dental School
Size of Practice
1-5 Staff
6-10 Staff
11-25 Staff
26+ Staff
Undergraduate School
Dental School
Specialty
Years in Practice
Years as an ADA Member
What information(s) are you most interested in obtaining?
Practice Management
Clinical Techniques
Work/Life Balance
Corporate vs Private Practice
Other
Tell us about yourself! What are your interests outside of dentistry?
Certification
I certify the information I provided on and in connection with this form is true and correct to the best of my knowledge. I also understand that any false statements or deliberate omissions on this form may subject me to legal actions for fraudulent misrepresentation.
SUBMIT STEP 1
Step2: Payment
Includes one year of KADA membership and KAOMI 2022: REBOOT, REBUILD Registration.
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Your Account
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Mentorship Program
Students
Student Membership
Student Programs
Student Chapters
Mentorship Program
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