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Referrals @ Pall Mall
The Pall Mall Dental & Dermal Clinic takes on referrals for Orthodontics, Periodontics, Endodontics, Prosthodontics and Oral Surgery. If you would like to refer a patient to us, please contact us.

15 Pall Mall
London SW1Y 5LU
Phone 020 7766 7150
Fax 020 7766 7151
admin@pmddc.co.uk
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Alternatively, please use the online referral form and then post other relevant details and x-rays.

Fields in bold are required.

Dentist's Name
Dentist's Address
Dentist's Tel (w)
Dentist's Tel (h)
Dentist's Tel (m)
Dentist's Email
Patient's Name
Patient's Address
Patient's Tel (w)
Patient's Tel (h)
Patient's Tel (m)
Patient's Email
Dental Specialty
Reason for Referral
Relevant Medical
History
Priority
Radiographs Please email or post radiographs separately.

  

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