Refer to us online.

Your referral is a trusted endorsement of our services that we handle with great responsibility. Our hope is that collectively, we can provide a high quality, comprehensive service that promotes dental health and wellness for your patients.
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Scarborough

2100 Ellesmere Rd, Unit 312 Scarborough, ON M1H 3B7

P 647-349-2100 F 647-349-2101

Professional Referral Scarborough

Patients Name

First Name

Last Name

Patients Date of Birth

YYYY

Parents Name

First Name

Last Name

Parents Phone

(###)

###

####

Please provide details of treatment request

Referring Dentist

First Name

Last Name

Dentist Email

Dentist Phone

(###)

###

####

Please email X-Rays and other important information to scarborough@sunrisekidsdental.com

Beaches

1089 Kingston Rd Toronto, ON M1N 4E4

P 647-350-7562 F 647-350-7615

Professional Referral Beaches

Patients Name

First Name

Last Name

Patients Date of Birth

YYYY

Parents Name

First Name

Last Name

Parents Phone

(###)

###

####

Please provide details of treatment requested

Referring Dentist

First Name

Last Name

Dentist Email

Dentist Phone

(###)

###

####

Please email x-rays and other important information to info@sunrisekidsdental.com

Professional Referral

Scarborough

Beaches

contact

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