Contact - Advantage Dental

Advantage Dental

Phone: 604-886-7308

Home
About Us
Services
Patient Resources
Contact

Home
About Us
Services
Patient Resources
Contact

Contact Us

You can find our office on the corner of Gibsons Way and Venture Way. It’s located on the second floor above The Blackfish Pub. Our location is wheelchair accessible.

Address: 968 Venture Way, Gibsons, BC V0N 1V7

Phone: (604) 886-7308

Fax: (604) 886-7390

Email: info@advantagedental.ca

Fill out this form to request an appointment

Someone from the Advantage Dental team will contact you shortly

Name *

First

Last

Email *

Phone Number *

Preferred Contact Method

By Email
By phone
By text message

Refer to us

Thank you for choosing Advantage Dental. We are excited to work with you and your patients. Please fill out the web form below and submit your referral. If you have questions or concerns please contact us by phone or email.

PATIENT INFORMATION

Patient's Name *

First

Last

Gender *

Female
Male

Date Of Birth (Month DD, YYYY) *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

Dental Insurance

Insurance Company

Group

Insurance ID

Insurance Holder

PHN

REFERRING PROFESSIONAL

Referring Professional *

MD, DMD, DDS, Other

Phone *

FAX

Email *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

REASON FOR REFERRAL

Reason(s) for referral *

Extractions
Root Canal
Restorations
Sedations

Sedations (please indicate an option below) *

Oral Sedation
Nitrous Oxide
IV Sedation
General Anaesthesia (Limited availability)

Type of Radiographs (i.e. Bitewing X-Ray, Panoramic X-Ray, Periapical X-Ray or other)

Date

How would you like to send us the x-rays?

Upload it here
In a separated Email
Faxed

X-rays Upload

Click or drag files to this area to upload. You can upload up to 4 files.

Please include patient's name on the file

Teeth of concern *

Notes

Family Dentistry with a creative touch. If you want a beautiful smile and exceptional dental care, we are here for you! Call and make your appointment today!

Phone: 604-886-7308

Contact Us

You can find our office on the corner of Gibsons Way and Venture Way. It’s located on the second floor above The Blackfish Pub. Our location is wheelchair accessible.

Fill out this form to request an appointment

Someone from the Advantage Dental team will contact you shortly

Refer to us

Thank you for choosing Advantage Dental. We are excited to work with you and your patients. Please fill out the web form below and submit your referral. If you have questions or concerns please contact us by phone or email.

PATIENT INFORMATION

REFERRING PROFESSIONAL

REASON FOR REFERRAL

Phone: 604-886-7308

© 2021 Advantage Dental Customized by Lime Marketing