New 3M Account Opening Form for Dental Practices

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This form is applicable if you fulfill the following criteria:

a) Your practice does not yet have a 3M account with Summit Company (M) Sdn Bhd
b) Your practice has a 3M account with Summit but you have not placed an order in the last 2 years

Do note that the information provided here will be shared with 3M's Warehouse & Distribution partner Summit Company (M) Sdn Bhd who will use this information to assist them in creating an account for your dental practice so you can purchase 3M Oral Care products.

Summit is 3M Malaysia's official partner who will be transacting with you for payments & delivery of goods to your practice.

If you have any questions please contact any one of our 3M representatives below:

3M Representative

Account Opening Form

Fill in the following details and we'll get started on opening a 3M account for you with Summit Company.

Title *

First Name *

Last Name *

Clinic Name *

City *

State *

Email *

Please share with us an email address that is used for official business matters by your practice.

Mobile Number *

Promotion you're interested in *

Agreement to 3M's Privacy Policy *

I agree to 3M's Privacy Policy as found at https://www.3m.com.my/3M/en_MY/company-my/privacy-policy/

Required

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