Invoice Orthodontist in France Paris –Free Word Template Download with AI
Member of the French Order of Dentists
INVOICE
Invoice Number: INV-2023-8942
Date of Issue: October 24, 2023
Due Date: November 24, 2023
From (Provider)Cabinet d'Orthodontie Parisienne
15 Avenue de l'Opéra, 75001 Paris, France
SIRET: 832 456 789 00012 | TVA Intracommunautaire: FR 12 832 456 789
Phone: +33 1 42 60 00 00 | Email: [email protected]
Bill To (Patient)Mr. Jean-Pierre Moreau
42 Rue de Rivoli, 75004 Paris, France
SS Number (Sécurité Sociale): 1 85 04 75 100 123 45
Complementary Insurance: Mutuelle Santé Plus
Treatment ReferenceCase ID: ORTH-2023-JPM
Treatment Plan: Comprehensive Fixed Appliance Therapy
Start Date: September 15, 2023
Estimated Duration: 24 Months
| Ref | Description of Orthodontic Services | Base Fee (€) | TVA (20%) | Total (€) |
|---|---|---|---|---|
| 01 |
Initial Diagnostic Consultation & Records Includes panoramic radiography, cephalometric analysis, and digital intraoral scanning. This foundational step is crucial for determining the precise orthodontic mechanics required for your specific malocclusion. |
150.00 | 30.00 | 180.00 |
| 02 |
Preventive Phase: Interceptive Orthodontics Placement of transpalatal arch (TPA) to stabilize molar position and create necessary space for alignment. This procedure is standard in complex cases within the Parisian dental district to ensure jaw harmony. |
450.00 | 90.00 | 540.00 |
| 03 |
Fixed Appliance System (Brackets & Bands) Supply and bonding of high-grade stainless steel brackets and molar bands. Includes the initial archwire placement. This constitutes the primary mechanical apparatus for tooth movement. |
1,200.00 | 240.00 | 1,440.00 |
| 04 |
Active Treatment Phase: Monthly Adjustments (Q4) Four months of active orthodontic adjustments (October - January). Includes wire changes, elastic placement, and torque adjustments to ensure optimal root parallelism and occlusal stability. |
800.00 | 160.00 | 960.00 |
| 05 |
Interproximal Reduction (IPR) Minimal enamel stripping to resolve mild crowding and improve contact points. Performed under local anesthesia to ensure patient comfort during the alignment phase. |
120.00 | 24.00 | 144.00 |
| 06 |
Emergency Visit & Bracket Re-bonding Repair of dislodged bracket on tooth #21 due to dietary non-compliance. Includes new bracket supply and adhesive curing. |
80.00 | 16.00 | 96.00 |
| Subtotal (HT) | 2,800.00 € |
| VAT (TVA 20%) | 560.00 € |
| TOTAL DUE (TTC) | 3,360.00 € |
Payment Terms & Conditions
Payment is due within 30 days of the invoice date. Please reference the Invoice Number (INV-2023-8942) on all payments. Late payments may incur a statutory interest rate as per French commercial law.
Bank Transfer Details:
Bank: BNP Paribas, Paris Opéra Branch
IBAN: FR76 3000 4000 0000 0000 0000 001
BIC: BNPAFRPP
Beneficiary: Cabinet d'Orthodontie Parisienne
Insurance Information:
This invoice is compliant with the French National Health Insurance (Assurance Maladie) fee schedule (Nomenclature Actes de Biologie Médicale).
Please submit this document to your complementary insurance provider (Mutuelle) for reimbursement according to your specific coverage plan.
Note that orthodontic treatments for adults over 21 years of age are subject to specific reimbursement limits in France.
Orthodontic Care Instructions:
As part of your treatment in our Paris clinic, please continue to avoid hard, sticky, or chewy foods to prevent appliance damage.
Maintain rigorous oral hygiene using the interdental brushes provided. Failure to comply may result in extended treatment time and additional costs.
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