Invoice Dentist in Ivory Coast Abidjan –Free Word Template Download with AI
Specialized Dental Care in Abidjan
123 Boulevard de la République, Plateau
Abidjan, Ivory Coast
Tel: +225 27 22 44 55 66
Email: [email protected]
RC Abidjan: B-2023-12345 | NINEA: 0000000000000
Invoice Number: INV-2023-10-089
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Service Location: Abidjan, Ivory Coast
Bill To:
Mr. Jean-Baptiste Kouassi
45 Rue des Jardins, Cocody Angré
Abidjan, Ivory Coast
Phone: +225 07 08 09 10 11
Email: [email protected]
Payment Information:
Bank: Ecobank Ivory Coast
Branch: Plateau Central
Account Name: Clinique Dentaire du Plateau SARL
Account Number: 0012345678901234
SWIFT/BIC: ECOBCICX
Currency: West African CFA Franc (XOF)
| # | Description of Dental Services | Quantity | Unit Price (XOF) | Total (XOF) |
|---|---|---|---|---|
| 1 |
Comprehensive Initial Consultation & Diagnostic Imaging Includes panoramic X-ray, clinical examination, and treatment planning consultation with lead dentist in Abidjan. |
1 | 25,000 | 25,000 |
| 2 |
Professional Dental Prophylaxis (Scaling & Polishing) Ultrasonic scaling to remove tartar and calculus, followed by manual polishing to ensure optimal oral hygiene standards. |
1 | 35,000 | 35,000 |
| 3 |
Root Canal Therapy (Endodontic Treatment) Complete endodontic treatment for tooth #36 (Mandibular Left First Molar). Includes anesthesia, pulp removal, canal shaping, and obturation. |
1 | 150,000 | 150,000 |
| 4 |
Composite Resin Fillings (Aesthetic Restoration) Tooth-colored composite filling for tooth #14 (Maxillary Right First Premolar) to restore function and aesthetics. |
1 | 45,000 | 45,000 |
| 5 |
Zirconia Dental Crown Fabrication & Placement High-strength zirconia crown for tooth #36. Includes tooth preparation, impression taking, temporary crown, and final cementation. |
1 | 280,000 | 280,000 |
| 6 |
Follow-up Examination & Occlusal Adjustment Post-treatment review to ensure proper bite alignment and healing progress of treated areas. |
1 | 15,000 | 15,000 |
Terms and Conditions:
1. Payment Terms: Payment is due within 14 days of the invoice date. Late payments may incur a penalty fee of 1.5% per month.
2. Currency: All amounts are quoted in West African CFA Francs (XOF), the official currency of Ivory Coast.
3. Validity: This invoice is valid for services rendered at our Abidjan clinic. Prices are subject to change without notice for future appointments.
4. Insurance: If you have dental insurance coverage, please submit this invoice to your provider for reimbursement. We can provide additional medical reports upon request.
5. Warranty: All restorative work, including crowns and fillings, comes with a 12-month warranty against defects in materials and workmanship.
6. Contact: For any questions regarding this invoice or your dental treatment plan, please contact our billing department in Abidjan.
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