GoldStar Pharmacy is able to supply your dental practice with commonly used prescriptions, catered to your specific needs. Call today to see how GoldStar can partner with your dental practice to provide legendary customer service to your patients.
GOLDSTAR PHARMACY OFFICE USE DENTAL ORDER FORM
4500 CARTER CREEK PARKWAY, SUITE 202, BRYAN, TX 7802 979-690-9112 (P) WWW.GOLDSTARRX.COM FAX COMPLETED FORM TO 855-201-8501
PRESCRIPTION ITEMS AND PRICING
| ITEM | QUANTITY | COST PER UNIT | TOTAL |
|---|---|---|---|
| Midazolam 2mg/ml Syrup | 118ml | Call for Pricing | |
| Hydroxyzine 10mg/5ml Solution | 473ml | Call for Pricing | |
| Triazolam 0.25mg tablet | 20 | Call for Pricing | |
| Amoxicillin 500mg Capsule | 100 | Call for Pricing | |
| Amoxicillin 250mg Capsule | 100 | Call for Pricing | |
| Miracle Mouthwash (lido/hydro/tetra/nyst/benadryl) | 240ml | Call for Pricing | |
| TAC dental Gel (lido20/tetra4/phenylephrine2%) | 60Gm | Call for Pricing | |
| Amoxicillin 250mg/5ml Suspension | 100ml | Call for Pricing | |
| Ammonia Inhalant 15% | 1 | Call for Pricing | |
| Ibuprofen 600mg tablet | 100 | Call for Pricing | |
| Meperidine HCl 50mg/5ml Soln (triplicate required) | 500ml | Call for Pricing | |
| Meperidine/Promethazine (triplicate required) | 480ml | Call for Pricing |