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Primary Partner
Gamma Dental Clinic
Partner Agent
Dr. John Smith
Scan Number
98736592
Patient Name
Israel Israeli
Patient Gender
Male
Item 1
Item 2
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Fixed Prosthetic
Removable Prosthetic
Type of restoration
Select an option
Type of implant crown
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Type of restoration
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Type of restoration
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Notes
17
16
15
14
13
12
11
21
22
23
24
34
35
26
27
47
46
45
44
43
42
41
31
32
33
24
34
35
36
37
Order summary
Item 1
Fixed Prosthetic 12, 11
$100.00
Item 2
Fixed Prosthetic 24, 31, 33
$150.00
Current Balance
$1,000.00
Total
$350.00
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