Quotation Estimate Dentist in Colombia Medellín –Free Word Template Download with AI
Professional Dental Services — Medellín, Colombia
Dental Practice Information
Clinic Name: Clínica Dental El Poblado
Address: Calle 10 # 43A-25, El Poblado, Medellín, Colombia
Phone: +57 (604) 444 5566
Email: [email protected]
NIT: 900.123.456-7
Lead Dentist: Dr. Carolina Restrepo, DDS, MSc
Client Information
Client Name: Mr. James Anderson
Address: 1234 Oak Street, Austin, TX 78701, USA
Phone: +1 (512) 555-0198
Email: [email protected]
Passport No.: US-4478-2291
Referral Source: Dental Tourism Agency
This Quotation Estimate has been prepared by Clínica Dental El Poblado, a fully licensed and accredited dental practice located in the heart of Medellín, Colombia. The following line items represent the comprehensive dental treatment plan recommended for the client after a full clinical evaluation, intraoral radiography, and digital smile design consultation conducted on June 10, 2025. All prices are quoted in Colombian Pesos (COP) with an equivalent reference in US Dollars (USD) at the exchange rate of 1 USD = 3,950 COP.
| # | Dental Procedure / Service | Description | Qty | Unit Price (COP) | Subtotal (COP) |
|---|---|---|---|---|---|
| 1 | Comprehensive Dental Examination & Digital X-Rays | Full oral assessment, panoramic radiograph, periapical X-rays (6 views), and periodontal charting | 1 | 350,000 | 350,000 |
| 2 | Professional Dental Cleaning (Prophylaxis) | Ultrasonic scaling, air-polishing, fluoride varnish application, and oral hygiene instruction | 1 | 280,000 | 280,000 |
| 3 | Composite Resin Dental Fillings | Tooth #14 and #24, Class II restorations using 3M Z350 XT composite material | 2 | 420,000 | 840,000 |
| 4 | Root Canal Treatment (Endodontics) | Tooth #36, single-visit endodontic therapy with rotary instruments and gutta-percha obturation | 1 | 1,850,000 | 1,850,000 |
| 5 | Ceramic Crown (Zirconia) | Tooth #36, full zirconia crown milled in-house, try-in, cementation with resin cement | 1 | 2,400,000 | 2,400,000 |
| 6 | Teeth Whitening (In-Office LED) | Single-session professional whitening using 35% hydrogen peroxide gel with LED activation | 1 | 650,000 | 650,000 |
| 7 | Custom Night Guard (Occlusal Splint) | Acrylic night guard fabricated from digital impression to protect restorations during sleep | 1 | 380,000 | 380,000 |
| 8 | Follow-Up Consultations (Post-Treatment) | Two follow-up visits at 2 weeks and 6 weeks for healing assessment and adjustment | 2 | 120,000 | 240,000 |
Terms & Conditions of This Quotation Estimate
- This Quotation Estimate is valid for 30 calendar days from the date of issue. After this period, prices may be adjusted due to material cost fluctuations in the Colombian market.
- All dental procedures will be performed by Dr. Carolina Restrepo or a senior associate dentist at the Medellín clinic, ensuring the highest standard of care.
- Payment terms: 50% deposit required to schedule the treatment; the remaining 50% is due upon completion of the final procedure. International wire transfer, credit card, and cash (COP/USD) are accepted.
- The dental treatment plan may be subject to minor adjustments following the clinical examination. Any additional procedures not listed in this Quotation Estimate will require written client approval before commencement.
- All restorations (zirconia crown, composite fillings) carry a 2-year warranty against manufacturing defects, provided the client adheres to the recommended oral hygiene protocol and attends scheduled follow-up visits.
- Medellín, Colombia, operates under the regulations of the Superintendencia Nacional de Salud. This dental practice holds active license No. 0456789 and complies with all national health and safety standards.
- The client acknowledges that this Quotation Estimate does not include airfare, hotel accommodation, or local transportation in Medellín. The clinic can provide recommended lodging partners upon request.
- Confidentiality: All patient records, radiographic images, and treatment plans are protected under Colombian data protection law (Ley 1581 de 2012) and will not be disclosed to third parties without written consent.
Dr. Carolina Restrepo, DDS, MSc
Lead Dentist — Clínica Dental El Poblado
Medellín, Colombia Accepted by (Client):
Mr. James Anderson
Signature & Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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