Orthodontic Referral

If you wish to refer a patient to us for treatment you can do so in a number of ways. You can write, email, telephone or fill in the form below and request a referral pack.
Download PDF Form here

Patient details

Oral Hygiene

Dentist details

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Align and Smile Limited is a private limited company registered in England, registered number 07852159.
Our registered office is Unit 6 New Providence Wharf, Blackwall Way, London, E14 9PA.
Docklands Dental Referral Centre is the trading name of Dr Sabena Bhuiyan.