Invoice Dentist in Nigeria Lagos –Free Word Template Download with AI
15 Admiralty Way, Lekki Phase 1
Lagos, Nigeria
Phone: +234 803 456 7890
Email: [email protected]
TIN: 12345678-0001
Invoice Number: LPDC-2024-0892
Date Issued: October 15, 2024
Due Date: October 30, 2024
Payment Status: Pending
Billed To:
Mr. Chukwudi Okafor
23 Adeola Odeku Street, Victoria Island
Lagos, Nigeria
Phone: +234 805 123 4567
Email: [email protected]
| Item # | Description of Dental Services | Quantity | Unit Price (NGN) | Total (NGN) |
|---|---|---|---|---|
| 1 | Comprehensive Dental Examination and Consultation - Initial assessment of oral health, including review of medical history and discussion of treatment options at our Lagos facility. | 1 | 15,000.00 | 15,000.00 |
| 2 | Full Mouth Digital X-Rays - Panoramic and periapical radiographs to assess bone structure, tooth positioning, and identify any underlying dental issues. | 1 | 25,000.00 | 25,000.00 |
| 3 | Professional Dental Cleaning (Prophylaxis) - Thorough scaling and polishing to remove plaque, tartar, and surface stains, promoting optimal oral hygiene. | 1 | 30,000.00 | 30,000.00 |
| 4 | Composite Fillings (3 Teeth) - Restoration of decayed teeth using tooth-colored composite material for both functionality and aesthetic appearance. | 3 | 20,000.00 | 60,000.00 |
| 5 | Root Canal Treatment (1 Tooth) - Endodontic therapy to remove infected pulp, clean and disinfect the root canal system, and seal the tooth to prevent further infection. | 1 | 85,000.00 | 85,000.00 |
| 6 | Dental Crown (Porcelain-Fused-to-Metal) - Custom-made crown to restore the shape, strength, and appearance of the treated tooth following root canal therapy. | 1 | 120,000.00 | 120,000.00 |
| 7 | Fluoride Treatment - Application of professional-grade fluoride to strengthen tooth enamel and provide additional protection against cavities. | 1 | 8,000.00 | 8,000.00 |
| 8 | Follow-up Consultation - Post-treatment examination to ensure proper healing and assess the success of completed dental procedures. | 1 | 10,000.00 | 10,000.00 |
| Subtotal: | ₦353,000.00 |
| Discount (5% Loyalty): | -₦17,650.00 |
| Value Added Tax (7.5%): | ₦25,233.75 |
| Total Amount Due: | ₦360,583.75 |
Important Notes:
This invoice represents the complete charges for dental services rendered at Lagos Premier Dental Clinic during the period specified. All prices are quoted in Nigerian Naira (NGN).
Please ensure payment is made within 15 days of the invoice date to avoid any late payment penalties. Our clinic is committed to providing the highest standard of dental care in Lagos, Nigeria, and we appreciate your trust in our professional services.
If you have any questions regarding this invoice or the treatments provided, please do not hesitate to contact our billing department. We are dedicated to ensuring transparency and clarity in all our financial communications with our valued patients.
Payment Information:
Bank Transfer:
Bank Name: First Bank of Nigeria
Account Name: Lagos Premier Dental Clinic Ltd.
Account Number: 1234567890
Swift Code: FBNINGLA
Online Payment:
Pay via our secure portal at: payments.lagospremierdental.ng
Cheque:
Make cheques payable to "Lagos Premier Dental Clinic Ltd." and mail to our office address listed above.
Authorized by:
Dr. Adebayo JohnsonLead Dentist
Lagos Premier Dental Clinic
Received by:
Patient SignatureDate: _______________ ⬇️ Download as DOCX Edit online as DOCX
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