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                    <input type="hidden" name="DATA[PRODUCT_ID]" value="93453">
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</div><div class="col-12 col-sm-6 col-md-6 col-lg-4
 col-xl-3 


 products__list__item" data-categories-ids="">
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                        <a href="https://www.newtechgloves.com/topicale-xtra-oral-anesthetic-gel.htm" title="Topicale Xtra Oral Anesthetic Gel 1oz." itemprop="image">
                            <img src="https://www.newtechgloves.com/picts/products/tn300x300-screenshot_2022-11-18_153346.webp" alt="Topicale Xtra Oral Anesthetic Gel 1oz." class="card-img-top">
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                    <span class="products__list__item__offer__price__caption"> Price:</span>
                    
                    
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                        $<span class="js_price_container" content="9.99" data-price="9.99" data-id="31629">9.99</span>
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	<span class="form_mandatory_error">Please fill up missing fields below</span>
</DIV>


	<div class="form-group row">
	    <label class="col-sm-4 control-label">First Name<b class="madatorystar">*</b></label>
	    <div class="col-sm-8">
	      <input type="text" value="" name="DATA[FNAME]" size="45" maxlength="255" dir="ltr" id="CONTACT_FNAME" class=" mandatory form-control" >
	    </div>
  	</div>
  	<div class="form-group row">
	    <label class="col-sm-4 control-label">Last Name<b class="madatorystar">*</b></label>
	    <div class="col-sm-8">
	      <input type="text" value="" name="DATA[LNAME]" size="45" maxlength="255" dir="ltr" id="CONTACT_LNAME" class=" mandatory form-control" >
	    </div>
  	</div>
	<div class="form-group row">
	    <label class="col-sm-4 control-label">E-mail<b class="madatorystar">*</b></label>
	    <div class="col-sm-8">
	      <input type="text" value="" name="DATA[EMAIL]" size="45" maxlength="255" dir="ltr" id="CONTACT_EMAIL" class=" mandatory form-control" >
	    </div>
  	</div>
	<div class="form-group row">
	    <label class="col-sm-4 control-label">Phone</label>
	    <div class="col-sm-8">
	     <input type="text" value="" name="DATA[PHONE]" size="45" maxlength="255" dir="ltr" id="CONTACT_PHONE" class=" form-control" >
	    </div>
  	</div>
  	
	<div class="form-group row">
	    <label class="col-sm-4 control-label">Ship to Country<b class="madatorystar">*</b></label>
	    <div class="col-sm-8">
	   	<select size="1" id="CONTACT_COUNTRY" name="DATA[COUNTRY]" dir="ltr" class=" mandatory form-control" ><option value="USA" class=" " >UNITED STATES</option><option value="CA" class=" " >CANADA</option><option value="MX" class=" " >MEXICO</option></select>
	    </div>
  	</div>
  	<div class="form-group row">
	    <label class="col-sm-4 control-label">System you are interested in</label>
	    <div class="col-sm-8">
	   <textarea cols="30" rows="2" id="CONTACT_SYSTEM" name="DATA[SYSTEM]" dir="ltr" class=" form-control" ></textarea>
	    </div>
  	</div>
  	

	<div class="form-group row">
	    <label class="col-sm-4 control-label">Comments</label>
	    <div class="col-sm-8">
	   <textarea cols="30" rows="2" id="CONTACT_COMMENTS" name="DATA[COMMENTS]" dir="ltr" class=" form-control" ></textarea>
	    </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://www.newtechgloves.com/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="gloves">
<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[cat_id]" value="topical-gels">

</FORM>

    </div>
  </div>
</div>


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<script>
  var sitehome = 'https://www.newtechgloves.com/',
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</script>
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<script src="css/main.js?v=2024"  type="text/javascript" ></script>
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<script src="js/jquery.adrecom.product_zoom.js?v=2024"  type="text/javascript" ></script>


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<script src="css/products.js?v=2024"  type="text/javascript" ></script>


<script src="../cms/js/firebase/app.js?v=2024"  type="module" ></script>
    

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</body>
</html><!--
Page: topical-gels, (Action: default) 
TOP template: users/gloves/templates/top.html
MIDDLE template: users/gloves/templates/mid_products.html
BOTTOM template: users/gloves/templates/bottom.html

Include: templates/inc_meta.html
Include: templates/inc_og_tags.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_top_scripts.html
Include: ./templates/inc_top_scripts.html
Include: templates/inc_top_acc_scripts.html
Include: templates/inc_top_search.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_login_top.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_top_menu.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_carusel.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_products_top.html
Include: templates/inc_products_qa.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_company_links.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_modals.html
Include: ./templates/inc_modals.html
Include: templates/inc_msh_modals.html
Include: templates/inc_add_address_modal_form.html
Include: templates/contact_form18.html
Include: templates/inc_popup_jan24.html
Include: templates/contact_form5.html
Include: templates/inc_login_dialog.html
Include: templates/contact_form10.html
Include: templates/contact_form3.html
Include: templates/inc_popup_modal.html
Include: /home/dental/web/skydentalsupply.com/public_html/cms/users/gloves/templates/inc_bot_scripts.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
Include: templates/lists/inc_list_price.html at module LIST_products
Include: ./templates/inc_sold_out.html at module LIST_products
Include: ./templates/contact_form17.html at module LIST_products
Include: templates/lists/inc_sorting.html at module LIST_products
Include: templates/lists/inc_navigator.html at module LIST_products

$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] ) 
$LIST_promotions Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/promotions_tabs_list.html
			 ITEM_TEMPLATE: templates/lists/promotions_tabs_item_point.html) 
$LIST_promotions [1] Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/promotions_tabs_list.html
			 ITEM_TEMPLATE: templates/lists/promotions_tabs_item_bigpict.html) 
$LIST_categories Type: LIST  (xml) (
			 ENTIRE_LIST_TEMPLATE: templates/lists/list.html
			 ITEM_TEMPLATE: templates/lists/left_categories_item.html) 
$LIST_products 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) 
-->