Dentist Referrals

We welcome your referrals and provide first-rate treatment, using the highest quality equipment and materials, within a pain and stress-free environment.  You can be assured that we will take great care of your patients, explaining our procedures and aftercare thoroughly.

Please fill in the form below if you would like to refer a patient to us for treatment.


    Need Appointment Within

    Payor Type

    Dentist Information

    Dental Practice Name

    Dentist Name

    Dentist Email

    Dentist Phone

    Practice Address

    Practice Postcode


    Patient Information

    Patient Name

    Patient Date of Birth

    Patient Email

    Patient Phone

    Patient Address

    Patient Postcode

    How did you find us?

    I consent to this form collecting the data I have provided so that Mill Hill Dental Practice can communicate with me and provide assistance. We will keep your information secure and never sell it to any third parties. Please check our Privacy Policy for more information.

    Call: 020 8959 1208

    8 Millway, Mill Hill
    London NW7 3RE

    Working Hours

    Monday - Friday- 9am - 7pm
    Out of Hours appointments available:
    7am - 9am and 7pm - 10pm
    Please Contact Us for information.

    Saturday - 9am - 5pm
    Out of Hours appointments available:
    7am - 9am
    Please Contact Us for information.

    Free Consultation