Fourth Avenue Dental Clinic Invoice PDF Jacob Jones Jan 14 2023
Document Details
2023
Lynsey Jones
Tags
Summary
This is a dental invoice for Jacob Jones from Fourth Avenue Dental Clinic in Vancouver, BC, dated January 14, 2023. The invoice details various dental procedures and payments.
Full Transcript
Fourth Avenue Dental Clinic 1905 West 4th Avenue Vancouver, BC, V6J 1M7 Phone # 604-736-2505 Fax # (604) 736-2503 Web: www.4thavenuedental.ca Email: [email protected]...
Fourth Avenue Dental Clinic 1905 West 4th Avenue Vancouver, BC, V6J 1M7 Phone # 604-736-2505 Fax # (604) 736-2503 Web: www.4thavenuedental.ca Email: [email protected] Invoice Statement Lynsey Jones 2174 W 8Th Avenue Vancouver, BC V6K 2A4 Jan/14/2023 Invoice#: 77016 Provider: Hygiene HYG 1 Jacob Jones Procedure Tooth # Surface Date of Service Status Fee($) 01202 Jan/14/2023 Complete $37.00 Recall Exam - Limited Oral Previous Pat 11101 Jan/14/2023 Complete $42.50 Polishing - One unit 12113 Jan/14/2023 Complete $21.10 FLUORIDE TREATMENTS (whole mouth) Varnish 11112 Jan/14/2023 Complete $101.00 Scaling - Two units Current Total: $201.60 Grand Total: $201.60 Payments Made Towards Invoice Date Applied Date of Payment Type Amount Paid Jan/14/2023 Jan/14/2023 Debit Card $201.60 Invoice is fully paid. Payment is Required on Date of Service Jan/14/2023 Printed by LiveDDM - The Doctor Company Inc. Page 1 of 1
