7131 Bathurst Street, Suite LL2
Thornhill, ON L4J 7Z1
Phone: 905 882 1839
Fax: 905 882 0771
To Our Patients Who Have Dental Insurance,
We are very pleased that you have selected us to perform your dental treatment. It is our wish that your dental health is the very best, that it can be. With the assistance that your insurance company provides, good health is a simple matter.
Your insurance coverage is an arrangement between your insurance company and your place of employment. There are many different policies and forms of coverage for example: some plans cover as little as 20% of dental treatment costs, while others cover as much as 100%. Please be aware that your coverage may not be based on the current dental fee guide. The amount of coverage that has been arranged does not involve the dentist. Our staff would be happy to complete your insurance forms and mail them to your insurance company. Your insurance company will in turn send the funds directly to this office. The unpaid portion that your dental plan does not cover is your responsibility.
  • The out of pocket portion must be paid at each appointment
  • You are responsible for any treatment no longer covered by your dental plan.
Please feel free to ask if you have any questions

Patient’s Acknowledgment: