At Mario Garita MP Dental Clinic we are willing to assist you in taking the decision for the dental treatment. Please fill the form below and wait for our estimate and proposal.  All fields are required when “optional” is not indicated.  Incomplete forms will not be considered.

Information about your case

(Optional) Attach any files that may be useful.

Panoramic X-Ray in JPG format. Please Max 5 Mb
Treatment plan that you received from your local dentist (PDF, JPG please Max 5Mb)

Pictures examples

Front
Right Side
Left Side
Open Lower
Open Upper
Pictures (as shown in this web page) (JPG or PNG please Max 5Mb)
By checking this box, I certify that the information I am sending to MARIO GARITA MP DENTAL CLINIC is true and it can be used by the specialists to review my case and prepare a dental treatment.