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		<div class="row form-group mb-3">
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		     <input type="text" value="" name="DATA[COMPANY]" size="45" maxlength="255" dir="ltr" id="ASK_COMPANY" class=" form-control" >
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		 <div class="row form-group mb-3">
		    <label class="col-md-4 col-form-label text-md-end">Phone Number</label>
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		     <input type="text" value="" name="DATA[PHONE]" size="45" maxlength="255" dir="ltr" id="ASK_PHONE" class=" form-control" >
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<input type="hidden" name="BUFFER" value="CONTACT_US">
<input type="hidden" name="section" value="contact_form">
<input type="hidden" name="TAG" value="CONTACT5">
<input type="hidden" name="ac" value="insert">
<input type="hidden" name="next_action" value="default">
<input type="hidden" name="next_section" value="contact_us_thanks">
<input type="hidden" name="onerror_section" value="products">


	<input type="hidden" name="params[field]" value="MANUF">
	<input type="hidden" name="params[search_value]" value="sultan-healthcare">
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</FORM>


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<div class="modal fade" ID="main_login_form_popup">
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                        <form action="https://dental.draft.webcart.us/index.php" method="post" name="login_form" id="main_login_form" class="">
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<div id="mm-quote" class="modal fade" tabindex="-1" aria-labelledby="mm-quoteLabel" aria-hidden="true">
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	<form action="index.php" method="post" name="contact_form" class="contact_form" data-json="1">

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							 <div class="col-md-8">
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						  <div class="row form-group mb-3">
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							  <input type="text" value="" name="DATA[EMAIL]" size="45" maxlength="255" dir="ltr" id="CONTACT10_EMAIL" class=" form-control mandatory mail" >
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<div class="modal fade" id="QUOTEModal" tabindex="-1" role="dialog" aria-labelledby="QUOTEModalLabel">
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<form action="index.php" method="post" name="contact_form" class="form-horizontal contact_form" data-ga-event-category="contact_form" data-ga-event-action="submit" data-ga-event-label="CONTACT3">
<div align="center" class="error_mess ajax_errors" style="display:none"></div>
<DIV class="form_err_message error_mess" align="center">
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</DIV>


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	    <div class="col-sm-8">
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	<div class="form-group row">
	    <label class="col-sm-4 control-label">E-mail<b class="madatorystar">*</b></label>
	    <div class="col-sm-8">
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	<div class="form-group row">
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	    <div class="col-sm-8">
	     <input type="text" value="" name="DATA[PHONE]" size="45" maxlength="255" dir="ltr" id="CONTACT_PHONE" class=" form-control" >
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	<div class="form-group row">
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	    <div class="col-sm-8">
	   	<select size="1" id="CONTACT_COUNTRY" name="DATA[COUNTRY]" dir="ltr" class=" mandatory form-control form-select" ><option value="USA" class=" " >UNITED STATES</option><option value="CA" class=" " >CANADA</option><option value="MX" class=" " >MEXICO</option></select>
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	<div class="form-group row">
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	    <div class="col-sm-8">
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	    </div>
  	</div>


      </div>
      <div class="modal-footer">
        <button type="button" class="btn btn-secondary" data-dismiss="modal">Close</button>
        <input type="hidden" name="DATA[SKU]" value="">
		<input type="hidden" name="DATA[PRODUCT_NAME]" value="">
		<input type="hidden" name="DATA[LINK]" value="https://dental.draft.webcart.us/products/">
		<input type="submit" name="submit" value="Request a Quote" class="btn btn-primary">

      </div>


<input type="hidden" name="BUFFER" value="CONTACT_US">
<input type="hidden" name="section" value="contact_form">
<input type="hidden" name="userid" value="">
<input type="hidden" name="TAG" value="CONTACT3">
<input type="hidden" name="ac" value="insert">
<input type="hidden" name="next_action" value="default">
<input type="hidden" name="next_section" value="contact_us_thanks">
<input type="hidden" name="onerror_section" value="products">
<input type="hidden" name="DATA[THE_TIME]" value="NOW()">


	<input type="hidden" name="params[field]" value="MANUF">
	<input type="hidden" name="params[search_value]" value="sultan-healthcare">
	<input type="hidden" name="params[page_idx]" value="2">

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</div>


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Include: templates/contact_form3.html
Include: templates/inc_popup_modal.html
Include: templates/inc_bot_scripts.html
Include: templates/inc_analytics.html
Include: templates/lists/inc_free_shipping.html at module LIST_viewcart
Include: templates/lists/inc_list_pictures.html at module LIST_products [1]
Include: templates/lists/inc_list_price.html at module LIST_products [1]
Include: ./templates/inc_sold_out.html at module LIST_products [1]
Include: ./templates/contact_form17.html at module LIST_products [1]
Include: templates/lists/inc_sorting.html at module LIST_products [1]
Include: templates/lists/inc_navigator.html at module LIST_products [1]

$LIST_products Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/list.html
			 ITEM_TEMPLATE: templates/lists/products_top_promo_item.html) 
$LIST_viewcart Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/cart-popup_list.html
			 ITEM_TEMPLATE: templates/lists/cart-popup_item.html
			 COLUMN:ID: (hard-coded) [BO] ) 
$TREE_products_categories_top Type: TREE  (xml) (
			 Level 1 DEFAULT: templates/trees/top_menu_item1.html
			 Level 1 PATH: templates/trees/top_menu_item1.html
			 Level 1 CURRENT: templates/trees/top_menu_item1.html
			 Level 2 DEFAULT: templates/trees/top_menu_item2.html
			 Level 2 PATH: templates/trees/top_menu_item2.html
			 Level 2 CURRENT: templates/trees/top_menu_item2.html
			 Level 3 DEFAULT: templates/trees/top_menu_item3.html
			 Level 3 PATH: templates/trees/top_menu_item3.html
			 Level 3 CURRENT: templates/trees/top_menu_item3.html) 
$LIST_top_menu_ex Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/list.html
			 ITEM_TEMPLATE: templates/lists/top_menu_ex_item.html) 
$LIST_manufs Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/manuf_list.html
			 ITEM_TEMPLATE: templates/lists/manuf_list_item.html) 
$LIST_cats4manuf Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/left_categories_list.html
			 ITEM_TEMPLATE: templates/lists/left_categories_item4vendor.html) 
$LIST_products [1] Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/products_list_list.html
			 ITEM_TEMPLATE: templates/lists/products_list_item.html) 
$LIST_pictures Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/list.html
			 ITEM_TEMPLATE: templates/lists/popuppict.html) 
-->