DentalHouse Group | DentalHouse Castor | Yaxley Dental Clinic

Referring professionals…

DentalHouse Castor

Yaxley Dental Clinic

Implant referral

Implant referral

Dr Bilal Hussain BDS MFDS RCS Edn REST Dip Imp Dip

Email – implants@dentalhouse.uk

Tel – 01733 245 055

114-116 Main Street
Yaxley
Peterborough
PE7 3LP

dr-hussain

Patient name *

Date of birth *

Address *

Phone

Mobile

Referring dentist *

Referring practice *

Address *

Mobile *

Email *

Site/Tooth number/Quadrant *

Number of implants *

Smoking status *

Peridontal health *

X-Rays *

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CBCT *

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Referral reason *

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