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NJDA Give Kids A Smile Supply Request

The ADA's 2022 Product Recipient List can be found here. If you are not receiving supplies through the ADA's Supply Lottery or wish to request additional supplies you may do so by completing this form. All supplies requested from NJDA must be picked up at NJDA Headquarters. NJDA does not ship supply boxes. NJDA will contact you to schedule a pick-up date. To receive supplies from NJDA you must be registered with both the ADA and NJDA GKAS Registration forms (2 separate forms).

Pick Up Location: NJDA Headquarters, One Dental Plaza, North Brunswick, NJ 08902
NJDA will contact you to schedule a pick up date.