Quotation Estimate Dentist in India Mumbai –Free Word Template Download with AI
Professional Dental Services — Mumbai, India
Dental Practitioner / Clinic
Dr. Ananya Deshmukh, BDS, MDS (Prosthodontics)
SmileCraft Dental Studio
402, Pearl Heights, Linking Road
Bandra West, Mumbai – 400050
Maharashtra, India
Phone: +91-98200-XXXXX
Email: [email protected]
Reg. No.: MDC-2019-44782
Client / Patient Details
Mr. Rajesh Kumar Patel
12, Sea Breeze Apartments
Andheri West, Mumbai – 400053
Maharashtra, India
Phone: +91-98330-XXXXX
Email: [email protected]
PAN: ABCDP1234F
This Quotation Estimate has been prepared by SmileCraft Dental Studio, a registered dental practice located in Bandra West, Mumbai, India, following a comprehensive clinical examination and diagnostic imaging (OPG, intraoral photographs, and digital X-rays) conducted on 10 June 2025. The following services and procedures are recommended for the patient’s complete oral rehabilitation. All pricing reflects current market rates for dental services in Mumbai, India, and includes the expertise of a qualified MDS-level dentist.
| S.No. | Dental Procedure / Service | Description & Scope of Work | Qty | Amount (INR) |
|---|---|---|---|---|
| 1 | Comprehensive Dental Consultation & Diagnostic Workup | Initial consultation with the treating dentist, full intraoral examination, digital panoramic radiograph (OPG), periapical X-rays (6 views), and treatment planning session. Includes digital smile design preview. | 1 | ’ 2,500 |
| 2 | Ultrasonic Scaling & Polishing (Full Mouth) | Removal of supragingival and subgingival calculus using ultrasonic scalers, followed by air-polishing and professional fluoride varnish application. Essential preventive dental care in Mumbai’s humid climate. | 1 | ’ 3,200 |
| 3 | Root Canal Treatment (RCT) — Molar (Tooth #36) | Single-visit root canal therapy on the lower left first molar using rotary NiTi instruments, rubber dam isolation, and gutta-percha obturation. Includes post-operative review visit. | 1 | ’ 8,500 |
| 4 | Full-Ceramic Crown (Zirconia) — Tooth #36 | Placement of a high-strength zirconia full ceramic crown over the RCT-treated molar. CAD/CAM milled in-house. Includes temporary crown, try-in appointment, and final cementation with resin cement. | 1 | ’ 12,000 |
| 5 | Composite Veneers — Upper Anterior (Teeth #11, #12, #21, #22) | Direct composite resin veneers on four upper front teeth for aesthetic correction of diastema and minor chipping. Includes shade matching, bonding, contouring, and polishing. A popular cosmetic dental procedure in Mumbai. | 4 | ’ 16,000 |
| 6 | Extraction of Impacted Wisdom Tooth (Tooth #48) | Surgical removal of a partially erupted lower right third molar under local anaesthesia. Includes pre-operative OPG review, flap reflection, sectioning if required, suturing, and post-operative medication. | 1 | ’ 6,500 |
| 7 | Professional Teeth Whitening (In-Office) | Single-session in-clinic whitening using 35% hydrogen peroxide gel with LED light activation. Includes pre-whitening gum protection, post-whitening desensitising gel, and take-home maintenance kit. | 1 | ’ 7,000 |
| 8 | Follow-Up Visits & Post-Operative Care | Three scheduled follow-up appointments (7 days, 30 days, 90 days) for RCT, crown, and extraction site review. Includes any necessary adjustments, re-cementation, or minor touch-ups. | 3 | ’ 1,500 |
| Subtotal (Treatment Charges) | ’ 57,200 |
| GST @ 18% (as applicable in India) | ’ 10,296 |
| Grand Total (Quotation Estimate) | ’ 67,496 |
- This Quotation Estimate is issued by SmileCraft Dental Studio, Bandra West, Mumbai, India, and is valid only for the patient named above. It is non-transferable.
- All dental procedures will be performed by Dr. Ananya Deshmukh or her designated associate dentist at the Mumbai clinic premises. No treatment will be conducted at any other location without prior written consent.
- Payment may be made via UPI (GPay, PhonePe, Paytm), NEFT/RTGS, credit/debit card, or cash. A GST-compliant tax invoice will be issued for every transaction as mandated by the Indian Goods and Services Tax Act, 2017.
- The patient agrees to attend all scheduled follow-up appointments. Cancellations must be communicated at least 24 hours in advance; otherwise, a 25% fee of the scheduled procedure will be charged.
- Warranty: Zirconia crown carries a 2-year warranty against manufacturing defects. Composite veneers carry a 1-year warranty. Root canal treatment is guaranteed for 1 year against re-infection, subject to patient compliance with oral hygiene instructions.
- In the event of any dispute, this Quotation Estimate shall be governed by the laws of India, and the competent courts in Mumbai, Maharashtra shall have exclusive jurisdiction.
- The patient acknowledges that dental outcomes, while planned meticulously, may vary due to individual biological factors. The treating dentist will communicate any deviations from this estimate before proceeding with additional work.
- This document constitutes a formal Quotation Estimate and does not constitute a binding contract until the patient signs the Acceptance section below and the advance payment is received.
For SmileCraft Dental Studio
Dr. Ananya Deshmukh, BDS, MDS
Principal Dentist & Proprietor
Signature & Clinic StampPatient / Client Acceptance
I, Rajesh Kumar Patel, have read and understood this Quotation Estimate.
I agree to the terms and conditions stated above.
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