Dentist referrals

Name: Dublin Orthodontist
Telephone: 01 837 1144

Thank you for looking to refer your patient to us at Dublin Orthodontist.

Below we have provided a simple form to refer your patient for private orthodontic or dental treatment. We look forward to working closely with you to help protect and transform your patient’s smile.

Field marked with * are mandatory

Referring dentist details

Dentist name*

Practice name*

Practice address*

Phone*

Email*

Patient details

Name*

Patient Date of Birth

Phone*

Email*

Parent/Guardian's name (if patient is under 18)

Address*

Reason for referral

By clicking submit you are agreeing to our privacy policy

Find Us

Dublin Orthodontist is conveniently located just 15 minutes from Dublin City Centre and 5 minutes from the M50 Ballymun exit. We are in the College Gate Clinic just across from DCU college. Now accepting new patients from Glasnevin, Finglas, Drumcondra, Santry, Ballymun, and all surrounding areas.

Dublin Orthodontist College Gate Clinic 123 Ballymun Rd
Dublin 9 D09 W523

Dublin Orthodontist 01 837 1144

Dublin Orthodontist Open in Google Maps