Referring Doctors/Dentists

20 Bloor Street East,Unit R4, Toronto, ON M4W 3G7

Mon - Fri 8:00am - 7:00pmSat 8:00am - 3:00pm

(416) 966-3368

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Have a dental emergency? Click HERE

Referring Doctors/Dentists

Home
Referring Doctors/Dentists
Our Practice
Dental Emergencies
Procedures
Appointment Request
Testimonials
Patient Info
Contact
Blogs

Seamless Referrals, Quality Results

Partner with us in delivering
exceptional dental care.

Refer Now

Dr. Vasant Ramlaggan D.D.S., H.B.Sc. & Associates

Sleep/TMD, Orthodontics, General Dentistry

Endodontics, Periodontics, Oral Surgery, Implant Dentistry

Saturday and Evening Appointments Available

Online Referral Form

Full Name*

DOB*

Guardian (If Minor)

Phone*

Email*

Tooth Numbers*

Right

12345678

910111213141516

3231302928272625

2423222120191817

Left

Reason for Referral Speech Pathology (expansion, airways, frenectomy, crowding, spaces, tongue habit)Orthodontic Exam (narrow palate, misalignment, crowding, cosmetics)TMD- Joint Dysfunction (jaw or muscle pain, misalignment, grinding)Halitosis (bad breath)General Restorative & Dental HygieneDental Emergency (teeth, tissues, trauma, cold sores)Oral Surgery (wisdom teeth, extractions, implants, velscope/cancer screening)Periodontics (gum disease, recessions, cold sore, frenectomy)Endodontics (tooth infection, abscess, trauma)Snoring and/or Sleep Apnea/Appliance Therapy (please include diagnosis and intake forms if possible)Sedation RequiredOther

Additional Information

Please CallBefore Consult/ExaminationAfter Consult/Examination

Referring Dr.

Date of Referral*

Note: We appreciate your referral and will contact the patient to book an appointment.

Midtown Dental

Midtown Dental is a Toronto Dental office dedicated to General & Cosmetic Dentistry including Exams, Dental Makeovers, Teeth Whitening, Veneers, Invisalign, Crowns, X-rays, Fluoride, Cleanings, & more.

Services

Cleanings Prevention
Cosmetic Dentistry
Braces and Orthodontics
Restorative Dentistry
sleep-apnea
Periodontal Therapy and Gum Disease
Wisdom Tooth Removal
Canker Sores
Dental Technology

Contact

Tel: (416) 966-3368
Address: 20 Bloor Street East, Unit R4, Toronto, ON M4W 3G7

BOOK NOW

Hours

Monday 8:00 A.M. - 7:00 P.M.
Tuesday 8:00 A.M. - 7:00 P.M.
Wednesday 8:00 A.M. - 7:00 P.M.
Thursday 8:00 A.M. - 7:00 P.M.
Friday 8:00 A.M. - 7:00 P.M.
Saturday 8:00 A.M. - 3:00 P.M.
Sunday CLOSED