We Will Accept Internet-Based Application for Examination.

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Later, we will contact you by e-mail, phone, or fax, for confirmation.

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*Before you transmit an application, we have a request.
1. Our clinic implements appointment-based examination in consideration of the content of treatment. You are to observe the appointment time without fail.
2. You are to follow necessary instructions for treatment, such as about brushing, and to undergo dental treatment in a sincere manner.
3. Regarding the content, period, and expenses of treatment, consultation time will be arranged after your mouth has been carefully examined, and treatment will be started only after that. (This will not apply in an emergency, however.)

1. Is this your first contact with this dental clinic?
YesNo

2.What is your current problem?
Teeth pain.When I chew, my teeth hurt.My teeth hurt when eating.
My mouth has a foul odor.
Gums or enlarged.My gums bleed.
Others

3.What kind of treatment do you want?
I would like to make my upper and lower teeth even.
I would like to whiten my teeth.
I would like to know about tooth implantation.
Others

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Q&A Corner
About Orthodontics About Implanting About Dental Esthetics About Periodontal Disease

Kichihei Goto Dental Clinic
20-1, Nanakita aza machi,Izumi-ku, Sendai 981-3131
TEL. : 022-372-9412 FAX : 022-372-9407
E-Mail :info@kippeichan.com
Treatment hours: 9:00 〜17:00, Monday through Saturday