LuxaBite/Luxatemp Automix Plus Dispensing Gun, Type 50, 4:1/10:1, 1/Pk, 110411

I hereby authorize Frontier Dental to initiate transactions to the Credit Card listed below, and, if necessary, initiate adjustments for any transactions credited/debited in error. This authority will remain in effect until written notification is received to cancel authorization with reasonable time to act upon it.