Thailand Dental Implant Clinic in Pattaya(Implants, Crown, Bridge, Veneer, Denture, Root Canal expert)

Reservation

Please, fill your information into reservation application form below.

First name *

Last name *

Birthday

Age

Email Address *

Telephone Number

Address

Country

Which treatment do you prefer ? *

Pick you up from your hotel ? *

Yes

If yes, which hotel/resident would you like us to pick you up ?

Note: the treatment that cost below than 10,000 THB will be charged 150 THB for round trip.

Airport transfer ?

Yes

Note: the treatment that cost below than 50,000 THB Airport transfer will be charged 2,000 THB per trip.

Addition detail:

* is require field.