Quotation Estimate Dentist in Argentina Buenos Aires –Free Word Template Download with AI
Professional Dental Services — Buenos Aires, Argentina
Quotation Reference No.: QTE-BA-2025-04872 | Date of Issue: 15 June 2025 | Valid Until: 15 July 2025
Dental Practice:Clínica Odontológica Buenos Aires
Av. Corrientes 2340, Piso 5
C1043 AAF — Buenos Aires, Argentina
Tel: +54 11 4321-5678
Email: [email protected]
CUIT: 30-71234567-8 Prepared For:
Mr. Alejandro Fernández Ruiz
Calle Sarmiento 1187, Depto 4B
C1083 AAB — Buenos Aires, Argentina
DNI: 28.456.789
Tel: +54 11 5555-9012
This Quotation Estimate has been prepared by Clínica Odontológica Buenos Aires, a licensed and registered dental practice operating in the city of Buenos Aires, Argentina, to provide Mr. Alejandro Fernández Ruiz with a comprehensive and transparent breakdown of the estimated costs associated with the proposed dental treatment plan. This document serves as a formal Quotation Estimate and does not constitute a binding contract until both parties have reviewed, agreed upon, and signed the acceptance section at the end of this document. All prices listed herein are expressed in Argentine Pesos (ARS) and are subject to the current exchange rate and national tax regulations in force in Argentina as of the date of issue.
Following a comprehensive clinical examination, radiographic imaging (periapical X-rays and panoramic radiograph), and periodontal evaluation conducted at our Buenos Aires clinic on 10 June 2025, the attending dentist, Dr. Mariana López (Matrícula Profesional Nº 12.345, Colegio de Odontólogos de la Ciudad de Buenos Aires), has identified the following conditions requiring treatment. The Quotation Estimate below reflects the full scope of recommended dental interventions to restore optimal oral health and function.
| Nº | Dental Procedure / Service | Description | Qty | Unit Price (ARS) | Subtotal (ARS) |
|---|---|---|---|---|---|
| 1 | Full Periodontal Scaling and Root Planing | Ultrasonic and manual debridement, all four quadrants | 1 | 48,500.00 | 48,500.00 |
| 2 | Composite Resin Restorations (Anterior) | Direct composite fillings, teeth #7, #8, #9, #10 | 4 | 22,000.00 | 88,000.00 |
| 3 | Porcelain-Fused-to-Metal Crown (PFM) | Tooth #14, including temporary crown and final cementation | 1 | 95,000.00 | 95,000.00 |
| 4 | Root Canal Treatment (Endodontics) | Tooth #21, single canal, including obturation | 1 | 78,000.00 | 78,000.00 |
| 5 | Full-Ceramic Crown (Zirconia) | Tooth #21, post-endodontic restoration | 1 | 110,000.00 | 110,000.00 |
| 6 | Extraction of Third Molar (Wisdom Tooth) | Tooth #38, surgical extraction under local anesthesia | 1 | 55,000.00 | 55,000.00 |
| 7 | Professional Dental Prophylaxis (Cleaning) | Polishing, fluoride varnish application, oral hygiene instruction | 1 | 18,500.00 | 18,500.00 |
| 8 | Digital Intraoral Photography and Records | Pre- and post-treatment documentation | 1 | 8,000.00 | 8,000.00 |
| 9 | Follow-Up Consultations (Post-Operative) | Three scheduled check-ups at 1 week, 1 month, and 3 months | 3 | 6,500.00 | 19,500.00 |
| 10 | Local Anesthesia and Medications | Lidocaine with epinephrine, analgesics, anti-inflammatory course | 1 | 12,000.00 | 12,000.00 |
| Subtotal (before taxes): | 532,500.00 ARS |
| IVA (21% — Argentine Value Added Tax): | 111,825.00 ARS |
| TOTAL ESTIMATED COST: | 644,325.00 ARS |
- Payment Schedule: The total amount of this Quotation Estimate may be settled in up to three (3) equal monthly installments of ARS 214,775.00, with the first installment due upon signing of the treatment consent form. No interest will be charged on installments paid within the agreed schedule.
- Accepted Payment Methods: Cash, bank transfer (CBU/CVU), debit/credit card (Visa, Mastercard, American Express), or Argentine electronic payment platforms (Mercado Pago, Transferencia Electrónica). All transactions are processed in Argentine Pesos (ARS) in accordance with the regulations of the Banco Central de la República Argentina (BCRA).
- Quotation Validity: This Quotation Estimate remains valid for thirty (30) calendar days from the date of issue. Due to fluctuations in the Argentine peso exchange rate and potential changes in the cost of imported dental materials, prices may be adjusted after the validity period expires.
- Cancellation Policy: Should the patient decide to cancel the treatment plan after the initial consultation but before any procedure has been performed, a non-refundable administrative fee of ARS 15,000.00 will apply. Cancellations after a procedure has commenced will be subject to a pro-rata charge for work already performed.
- Warranty: All restorative work (crowns, composite fillings) carries a warranty of twelve (12) months from the date of final cementation, covering defects in materials or workmanship under normal use. This warranty does not cover damage resulting from trauma, bruxism, or failure to attend scheduled follow-up appointments.
- Regulatory Compliance: All dental procedures described in this Quotation Estimate will be performed in strict compliance with the regulations established by the Colegio de Odontólogos de la Ciudad de Buenos Aires and the national health standards set forth by the Ministerio de Salud de la Nación, Argentina. Informed consent will be obtained prior to each procedure.
By signing below, the patient acknowledges having received and reviewed this Quotation Estimate for dental services at Clínica Odontológica Buenos Aires. The patient confirms understanding of the proposed treatment plan, the associated costs in Argentine Pesos, the payment terms, and the conditions outlined in this document. The patient authorizes the attending dentist and the clinical team to proceed with the dental treatments as described, subject to the clinical judgment of the treating professional.
Patient SignatureAlejandro Fernández Ruiz
DNI: 28.456.789
Date: _______________ Dental Practice Representative
Dr. Mariana López
Matrícula Nº 12.345
Clínica Odontológica Buenos Aires
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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