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Our Doctors
Services
Root Canal Treatment
Root Canal Retreatment
Root end surgery or Apicoectomy
Cracked Tooth Management
Dental Trauma Management
Regenerative Endodontics
Referring Dentist
Contact Us
Referring Dentists
*
Enter Full Name
*
Referring Dentist :
NRIC
Date of Referral :
*
HP / Tel ( H )
*
Clinic Email :
*
Clinic ( Branch ) :
Please Indicate
Treatment Needed
Tooth Number
Please Indicate
Tooth Number
Crack Tooth/ Pain Assessment
Crack Tooth/ Pain Assessment
Root Canal Treatment
Root Canal Treatment
Root Canal Retreatment
Root Canal Retreatment
Post Core Composite
Post Core Composite
Apicoectomy
Apicoectomy
X-ray
X-ray attached (1 x-ray attachment allowed),
not more than 5mb
Referral Notes
(For referring dentist, a copy of the online referral will be sent via the clinic email provided)
