Invoice Dentist in Germany Munich –Free Word Template Download with AI
Dr. med. dent. Hans Mueller & Associates
Maximilianstrasse 35, 80539 Munich, Germany
Phone: +49 89 1234 5678 | Email: [email protected]
VAT ID (USt-IdNr.): DE123456789
Chamber of Dentistry: Bayerische Zahnärztekammer
Official Dental Billing Statement
Bill To (Patient)
Max Mustermann
Marienstrasse 12, 80331 Munich, Germany
Insurance Provider: TK (Techniker Krankenkasse)
Policy Number: 1234567890
Patient ID: MM-2023-001
| No. | Description of Dental Services | GOZ Code / Fee Schedule | Multiplier | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|---|
| 1 | Comprehensive initial consultation and oral examination including periodontal screening and risk assessment. | GOZ #01.01 | 2.3 | € 45.00 | € 103.50 |
| 2 | Full mouth panoramic X-ray (OPG) and periapical radiographs for diagnostic planning. | GOZ #03.02 | 2.0 | € 35.00 | € 70.00 |
| 3 | Professional teeth cleaning (Prophylaxis) including scaling and polishing using ultrasonic devices. | GOZ #05.01 | 2.5 | € 80.00 | € 200.00 |
| 4 | Restorative dentistry: Composite filling on tooth #36 (lower left first molar) with isolation. | GOZ #08.01 | 2.3 | € 65.00 | € 149.50 |
| 5 | Endodontic treatment: Root canal therapy on tooth #11 (upper right central incisor), single canal. | GOZ #12.01 | 2.5 | € 120.00 | € 300.00 |
| 6 | Prosthetic dentistry: Ceramic crown preparation and temporary crown placement for tooth #11. | GOZ #15.01 | 2.3 | € 95.00 | € 218.50 |
| 7 | Follow-up consultation and evaluation of healing progress post-procedure. | GOZ #01.01 | 1.8 | € 45.00 | € 81.00 |
Important Notes & Payment Instructions
Bank Details for SEPA Transfer:
Bank Name: Bayerische Landesbank
IBAN: DE89 7005 0000 0000 1234 56
BIC: BYLADEM1001
Reference: INV-2023-10-045 / Max Mustermann
Legal Notice:
This invoice is issued in accordance with the German Fee Schedule for Dental Services (Gebührenordnung für Zahnärzte - GOZ). The multipliers applied reflect the complexity of the treatment and the specific requirements of the case. In Munich, as a major economic hub in Germany, dental care standards adhere strictly to the regulations set by the Bavarian Chamber of Dentistry.
Payment Terms:
Payment is due within 30 days of the invoice date. Late payments may incur interest charges as per German commercial law (§ 288 BGB). Please ensure that the invoice number is included in the payment reference to facilitate quick processing.
Insurance Information:
If you have private dental insurance, please submit a copy of this invoice along with the treatment plan to your provider for reimbursement. Our clinic in Munich is equipped to handle billing for both statutory (gesetzlich) and private (privat) insurance patients.
Contact:
For any questions regarding this invoice or your dental treatment, please contact our billing department at +49 89 1234 5678 or visit us at our clinic in Munich.
Authorized Signature
Dr. med. dent. Hans MuellerHead Dentist ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT