Invoice Dentist in Germany Frankfurt –Free Word Template Download with AI
Dr. med. dent. Hans Mueller & Associates
Mainzer Landstraße 120
60329 Frankfurt am Main, Germany
Tel: +49 69 12345678
Email: [email protected]
VAT ID: DE123456789
Invoice Number: INV-2023-10-045
Date: October 24, 2023
Due Date: November 24, 2023
Reference: Patient ID #88421
Bill To:
Max Mustermann
Berliner Straße 45
60311 Frankfurt am Main, Germany
Insurance Provider: TK (Techniker Krankenkasse)
Insurance Number: TK-987654321
| No. | Description of Dental Services | GOZ/Heilplan Code | Qty | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|---|
| 1 | Comprehensive dental examination including oral cancer screening and periodontal assessment. This initial consultation is essential for establishing a baseline for your oral health in our Frankfurt clinic. | 01.01 | 1 | 85.00 | 85.00 |
| 2 | Full mouth panoramic X-ray (OPG) and periapical radiographs. Advanced imaging technology used to detect hidden cavities, bone loss, and other structural issues. | 03.02 | 1 | 120.00 | 120.00 |
| 3 | Professional dental cleaning (Prophylaxis) including ultrasonic scaling and polishing. Recommended annually to prevent gum disease and maintain optimal hygiene. | 06.01 | 1 | 150.00 | 150.00 |
| 4 | Composite filling (Tooth #36). Restoration of a molar with tooth-colored material to match natural aesthetics and restore function. | 05.04 | 1 | 180.00 | 180.00 |
| 5 | Root canal treatment (Tooth #11). Endodontic therapy to save a severely decayed tooth, including cleaning, shaping, and sealing of the root canal system. | 04.05 | 1 | 450.00 | 450.00 |
| 6 | Ceramic crown preparation and temporary crown placement (Tooth #11). High-quality zirconia crown to protect the treated tooth and restore its appearance. | 07.02 | 1 | 650.00 | 650.00 |
| 7 | Local anesthesia and pain management during procedures. Ensures patient comfort throughout all dental treatments performed at our Frankfurt location. | 02.01 | 2 | 25.00 | 50.00 |
| 8 | Follow-up consultation and adjustment of crown fit. Ensures proper occlusion and patient satisfaction with the final restoration. | 01.03 | 1 | 60.00 | 60.00 |
Payment Information:
Bank Name: Commerzbank AG
IBAN: DE89 5004 0000 0012 3456 78
BIC: COBADEFFXXX
Account Holder: Frankfurt Dental Clinic GmbH
Reference: Please use Invoice Number INV-2023-10-045 as payment reference.
Important Notes:
This invoice is issued in accordance with German tax regulations and the Gebührenordnung für Zahnärzte (GOZ). All services were rendered at our clinic in Frankfurt am Main, Germany. Payment is due within 30 days of the invoice date. Late payments may incur interest charges as per German commercial law.
If you have any questions regarding this invoice or your dental treatment, please contact our office during business hours (Monday-Friday, 8:00 AM - 6:00 PM). We are committed to providing you with the highest standard of dental care in Frankfurt.
Please note that this invoice is valid for tax purposes and should be kept for your records. In case of discrepancies, please notify us within 14 days of receiving this document.
Thank you for choosing Frankfurt Dental Clinic for your oral health needs. We appreciate your trust in our professional services.
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