Rich Dental Hospital
9505092323
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Patient Intake & Registration

Please complete this form prior to your first clinical appointment to help us tailor your treatment plan.

Confidential Document

Intake Information

1. Personal Information

2. Dental History

3. Medical History & Conditions

4. Consent & Submission

General Contact 9505092323 info@richdentalhospital.com
Hospital Location

D.No: 16-2-131, Kasturidevi Nagar,
Pogathota, SPSR Nellore District,
Andhra Pradesh – 524001

Clinical Hours

Mon – Sat: 9:30 AM – 8:30 PM
Sunday: 9:30 AM – 1:30 PM

Treatments Root Canal Treatment Crowns & Bridges Dentures (Partial & Complete) Orthodontics Treatment Dental Implants
Rich Dental Hospital

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Address

D.No: 16-2-131, Kasturidevi Nagar,
Pogathota, SPSR Nellore District,
Andhra Pradesh – 524001

Contact Details 9505092323 info@richdentalhospital.com