this form expires in 3 hours
Smile Factory Dental Clinic
SFDC Cubao
Request an appointment
Patient Details
Appointment Details
Patient Details
First Name
*
Middle Name
Last Name
*
Suffix
Mobile Number
Email Address
Birth Date
*
Branch
*
Unspecified
SFDC Cubao
SFDC Fairview
SFDC Tungko
Purpose of Visit
*
Available services
Select purpose of visit from the services below.
Braces adjustment
30 minutes
Braces adjustment + TADS placement
30 minutes
Braces adjustment with dental filling
dental braces adjustment with pasta ng ngipin
30 minutes
Braces adjustment with tooth extraction
braces adjustment with bunot ng ngipin
30 minutes
Dental cleaning
oral prophylaxis or linis ng ngipin.
30 minutes
Dental filling
Pasta
an hour
Dental whitening
an hour
Denture
30 minutes
Fixed bridge or dental crown
an hour
Follow up
30 minutes
Gum reshaping
30 minutes
Installation of dental braces
an hour
It’s not on the list
please indicate your concern on the message and we will get back to you :)
30 minutes
Odontectomy
surgical removal of impacted tooth
2 hours
Oral consultation
For oral assessment or check-up
30 minutes
Reattachment of loose bracket/s
Please don’t forget to bring your dislodged bracket.
30 minutes
Removal of braces
30 minutes
Retainers
30 minutes
Root canal treatment
an hour
TMJ consulatation
Please bring your panoramic xray and TMJ scan with open and close view.
an hour
Tooth extraction
bunot ng ngipin
an hour
Close
Message
Next
Patient Details
Appointment Details
