Invoice Dentist in Morocco Casablanca –Free Word Template Download with AI
Dr. Ahmed Benali, D.D.S.
123 Boulevard Mohammed V
Maarif, Casablanca 20250
Morocco
Tel: +212 522 123 456
Email: [email protected]
ICE: 001234567890123
TVA: 00123456789
Date: October 24, 2023
Due Date: November 24, 2023
Invoice #: INV-2023-0892
Bill To:
Sarah Johnson
45 Rue Ibn Battouta
Anfa, Casablanca 20100
Morocco
ID/Passport: A12345678
| Description of Dental Services | Code | Qty | Unit Price (MAD) | Total (MAD) |
|---|---|---|---|---|
| Comprehensive Dental Examination and Consultation | D0150 | 1 | 350.00 | 350.00 |
| Full Mouth Panoramic X-Ray | D0330 | 1 | 400.00 | 400.00 |
| Professional Dental Cleaning (Prophylaxis) | D1110 | 1 | 500.00 | 500.00 |
| Composite Filling (Tooth #14) | D2391 | 1 | 800.00 | 800.00 |
| Root Canal Therapy (Tooth #19) | D3330 | 1 | 2,500.00 | 2,500.00 |
| Porcelain Crown Preparation and Placement | D2750 | 1 | 3,200.00 | 3,200.00 |
| Local Anesthesia | D9920 | 1 | 150.00 | 150.00 |
| Emergency Dental Visit Fee | D9999 | 1 | 200.00 | 200.00 |
Terms and Conditions:
1. Payment is due within 30 days of the invoice date. Late payments may incur a 2% monthly interest charge.
2. All dental services provided are subject to the professional standards of the Moroccan Dental Association.
3. Insurance claims must be submitted within 60 days of treatment. This invoice can be used for reimbursement purposes.
4. Any questions regarding this invoice should be directed to our billing department at +212 522 123 456.
5. This document serves as an official receipt for tax purposes in Morocco.
Authorized Signature
Dr. Ahmed Benali
Received By
Sarah Johnson
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