Refer a Patient


   Please choose one of our specialists:

Izchak Barzilay
  Prosthodontist
  416.322.6862


M.K. (Bobby) Baig
 Prosthodontist
 416.322.6862

Effrat Habsha
 Prosthodontist
 416.322.6862


Ryan Schure
 Periodontist
 416.322.6862



Peter Birek
 Periodontist
 416.486.3020


Amir Azarpazhooh
 Endodontist
 416.322.6862

David Chvartszaid
 Prosthodontist/Periodontist
 416.322.6862





Referring Doctor:

Doctor First Name:
*
Doctor Last Name:
*
Doctor Email Address:
*
Doctor Phone Number:
*
*required field
   


Radiographs to follow:
 

Submitted by:
 

Dentist
Other


2300 Yonge Street, Suite 905, Box 2334

Toronto ON M4P 1E4

info@buildyoursmile.com

YOUR SMILE. OUR SPECIALTY.



Patient Information:

Patient First Name:
*
Patient Last Name:
*
Patient Email Address:
*
Patient Phone Number:
*
*required field
   
 

 
Reason for Referral:

Implants
TMD/Pain
Removable Prosthodontics
Fixed Prosthodontics
Other


Additional Information:

We thank you for your referral and will contact your office to confirm intake. If there is anything we can do to serve you better, please let us know.





   For You Prosthodontic Associates - Your Smile. Our Specialty.
Dental Patient Forms
Office Publications
Oral Health Questions
Careers at Our Office
Like Us on Facebook
Follow Us on Twitter
Watch our videos on YouTube
Monday 8:30am - 4:30pm
Tuesday 8:30am - 4:30pm
Wednesday 8:30am - 4:30pm
Thursday 8:30am - 4:30pm
Friday 8:30am - 3:30pm
appointment button
Prosthodontic Associates
2300 Yonge Street
Suite 905, Box 2334
Toronto, Ontario Canada M4P 1E4

Your Toronto Dental Office

Click here for directions.
HOME OUR TEAM OUR SERVICES OUR OFFICE SUCCESS STORIES CONTACT US
        © Prosthodontic Associates