*TitleProfAssoc. ProfAsst. ProfDr*First NameMiddle Name*Last NameUser TypeGeneral MemberLife MemberAdvisorEC MemberDIAB Certified Imolantologist*Username*Password*Confirm Password*EmailSecondary Email*GenderMenWomen*Date of birth Present address*Permanent addressChamber AddressPhoneSecondary PhoneFax numberWebsiteSpecializationOral & Maxillofacial SurgeryPeriodontologyProsthodonticsOrthodonticsEndodonticsOperative DentistryOther TrainingHighest Education level GraduatePostgraduatePhDPost DocBMDC or Respective Dental Council NumberDIAB Membership NumberMembership TypeAffiliation/ Membership of any other AssociationYesNoValid Till SchoolCollegeGraduate SchoolPostgraduate SchoolEnrolled Program (Of DIAB)Workplace 1Workplace 2DIAB event detailsYesNoBimonthly DIAB Update (by email)YesNoDIAB Journal (by post)YesNoCommunications from Company Members of DIABYesNoDo you want your professional address to be included on a database of DIAB members that can be searched by the public on the DIAB's Certified Implantologist List? YesNoDo you want your professional address to be included on a database of DIAB members that can be searched by DIAB members on the DIAB website?YesNo*CityBargunaBarisalBholaBandarbanBrahmanbariaBagerhatBoguraChandpurChattogramCumillaCox's BazarChapainawabganjChuadangaDhakaDinajpurFaridpurGazipurGaibandhaJhalokatiPatuakhaliPirojpurFeniKhagrachhariLakshmipurNoakhaliRangamatiGopalganjKishoreganjMadaripurManikganjMunshiganjNarayanganjNarsingdiRajbariShariatpurJessoreJhenaidahKhulnaKushtiaMaguraMeherpurNarailJamalpurMymensinghNetrokonaSherpurJoypurhatNaogaonNatorePabnaRajshahiKurigramLalmonirhatNilphamariPanchagarhRangpurHabiganjMoulvibazarSirajganjSatkhiraSunamganjSylhetTangailThakurgaon*AreaMohammadpurMirpurUttaraGulshanBaridharaDhanmonddiMotijheelGulistanMalibagMogbazarBananiRampuraPhoto Upload Remove Accept our Terms&Conditions