Quotation Estimate Dentist in Ivory Coast Abidjan –Free Word Template Download with AI
Professional Dental Services — Abidjan, Ivory Coast
Dental Practice Information
Clinique Dentaire du Plateau
45 Boulevard Latrille, Plateau District
Abidjan, Ivory Coast
Tel: +225 27 22 45 67 89
Email: [email protected]
Registration No: CI-ABJ-DENT-2019-0042
Prepared For (Client)
Mr. Kouassi N'Guessan
12 Rue de la Paix, Cocody District
Abidjan, Ivory Coast
Tel: +225 07 08 12 34 56
Email: [email protected]
This Quotation Estimate has been prepared by our Dentist team at Clinique Dentaire du Plateau, located in the heart of Abidjan, Ivory Coast, following a comprehensive clinical examination conducted on 10 June 2025. The following line items represent the full scope of recommended dental treatments, diagnostic procedures, and associated materials. All pricing reflects current market rates for dental care in Abidjan, Ivory Coast, and includes the expertise of our licensed dental professionals.
| Ref | Description of Dental Service | Quantity | Unit Price (XOF) | Total (XOF) |
|---|---|---|---|---|
| 01 | Full oral examination, intraoral photography, and comprehensive diagnostic assessment by the lead Dentist | 1 | 25,000 | 25,000 |
| 02 | Full-mouth panoramic radiograph (OPG) and four periapical X-rays for diagnostic imaging | 1 | 35,000 | 35,000 |
| 03 | Ultrasonic scaling and professional dental cleaning (prophylaxis) — upper and lower arches | 1 | 45,000 | 45,000 |
| 04 | Root canal treatment (endodontic therapy) on molar tooth #36, including gutta-percha obturation | 1 | 180,000 | 180,000 |
| 05 | Full ceramic crown (zirconia) fabrication and cementation on tooth #36 following root canal | 1 | 250,000 | 250,000 |
| 06 | Composite resin restoration (tooth-colored filling) on premolar tooth #24 | 1 | 60,000 | 60,000 |
| 07 | Extraction of impacted third molar (wisdom tooth) #48 under local anesthesia | 1 | 120,000 | 120,000 |
| 08 | Post-operative follow-up consultation and suture removal (Day 7 and Day 14 visits) | 2 | 15,000 | 30,000 |
| 09 | Prescription of post-operative antibiotics, analgesics, and antiseptic mouthwash | 1 | 12,000 | 12,000 |
| 10 | Dental care plan documentation and written aftercare instructions in French and English | 1 | 10,000 | 10,000 |
| Subtotal (Services & Materials) | 767,000 XOF |
| VAT @ 18% (Ivory Coast Standard Rate) | 138,060 XOF |
| GRAND TOTAL | 905,060 XOF |
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. After the expiry date, prices may be subject to revision based on changes in material costs or exchange rates applicable in Ivory Coast.
- All dental procedures outlined in this estimate will be performed by a licensed Dentist registered with the Ordre des Médecins-Dentistes de Côte d'Ivoire. The lead practitioner for this treatment plan is Dr. Aya Koné, DDS, with over twelve years of clinical experience in Abidjan.
- Payment is due in full prior to the commencement of any invasive dental procedure. We accept bank transfer (mobile money via Orange Money, MTN MoMo, or Wave), cash, and major credit cards. A 50% deposit is required to schedule the treatment appointments.
- The quoted prices include all standard materials, local anesthesia, and clinical consumables. Any additional procedures identified during treatment that were not anticipated at the time of examination will be communicated to the patient in writing before proceeding, and a supplementary Quotation Estimate will be issued.
- All treatments are subject to a standard one-year warranty on restorative work (crowns, fillings) provided the patient adheres to the aftercare instructions issued by our Dentist team. Root canal treatments carry a two-year warranty.
- This practice operates in compliance with all health and safety regulations set forth by the Ministère de la Santé et de l'Hygiène Publique of the Republic of Ivory Coast. All instruments are sterilized using Class B autoclave protocols, and single-use items are disposed of in accordance with Ivorian biomedical waste management standards.
- The patient acknowledges that this Quotation Estimate is a good-faith estimate of costs and does not constitute a binding contract until a signed treatment consent form is completed at the clinic in Abidjan.
- For international patients or residents of Abidjan requiring insurance billing, our office will provide itemized invoices compatible with major international health insurance providers operating in Ivory Coast.
By signing below, the patient authorizes the Dentist and clinical team at Clinique Dentaire du Plateau, Abidjan, Ivory Coast, to proceed with the dental treatments described in this Quotation Estimate. The patient confirms that all medical history, allergies, and current medications have been disclosed to the treating practitioner.
Patient / Authorized Representative
Name: _________________________Signature & Date: _________________________
Dr. Aya Koné, DDS
Lead Dentist — Clinique Dentaire du Plateau
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