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Dental Clinic Partner Form
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Lead your license
Name of the Doctor
First
Last
Clinic Name
Contact Email
Services Offered
General Dentistry
Cosmetic Dentistry
Implants
Orthodontics
Oral Surgery
Other (please specify below)
Clinic Address
Does your clinic offer the following?
Digital X-rays
Medical grade sterilization protocol
In-house lab
Clinic Registration Number/ license
Lead Dentist’s Qualification
Additional Comments
Apply to Become a Clinic Partner
Where every journey ends with a smile and begins a story worth telling.
Dantayatra – Crafted Care. Curated Experiences. Confident Smiles.
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