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Dentist Referrals

Dr Athyr Al-Killidar is recommended by a number of dental practitioners for the treatment of Orthodontic and TMJ problems. He is an Invisalign Platinum Elite Doctor and is experienced with conventional orthodontics, Lingual braces and Damon braces. He is a member of the British Orthodontic Society, and his treatment philosophy is to base treatment planning on facial profile and health of the TMJs. If you would like to recommend a patient, you can either:-

  • click here to download a form, complete it and send/ fax it to our Practice; or
  • complete the form below:
Patients Details  
Title:
Date of Birth:
Surname:
Forenames:
Address
Postcode
Telephone/ Mobile
E-mail
Treatment requirement TMJ
Medical History
   
Referring Practitioner  
Full Name
E-mail
Observations
   
  If you have any digital radiographs or images that you would like to send with this referral, please e-mail them to athyr@londonsmile.com
   
 

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217 Edgware Road
London
W2 1ES
t: 020 7723 5424

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