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Free dental template

Free Dental Invoice Template

Invoice your dental patients with pre-loaded CDT codes for exams, cleanings, X-rays, and fluoride. Edit anything, preview, then save as PDF — all in your browser.

Invoice status

Ready to export or send.

100%
Invoice details
From (you)
To (client)
Line items
Tax & notes

Your Business Name you@yourbusiness.com 123 Main St, Suite 100, New York, NY 10001

INVOICE

INV-001

Bill to

Client Name client@clientcompany.com 456 Park Ave, Floor 3, New York, NY 10022

Issue date

2026-08-07

Due date

2026-09-06

Payment terms

Net 30

DescriptionQtyRateAmount
Comprehensive exam (D0120)1$95.00$95.00
Prophylaxis — Adult (D1110)1$120.00$120.00
Bitewing X-rays (D0274)1$75.00$75.00
Fluoride treatment (D1208)1$45.00$45.00
Subtotal$335.00
Total$335.00

Notes

Thank you for your business!

Export noteUse Print / Save PDF after the invoice is complete. The exported document hides editing controls automatically.

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Dental Business Benchmarks

Key metrics

  • Average rate: $75–$300/procedure; varies by insurance
  • Common services: cleanings & exams, fillings & crowns, orthodontics, cosmetic dentistry, oral surgery
  • Payment terms: Due at time of service; payment plans available for major procedures

Typical invoice line items

  • procedure code (CDT)
  • provider name
  • insurance estimate
  • patient responsibility
  • lab fees
See full industry benchmarks →

How to use this template

  1. Add practice name, dentist name, NPI number, and contact info
  2. List each procedure with CDT code, tooth number, and fee
  3. Show insurance estimated coverage and patient responsibility
  4. Include lab fees, consultation fees, and imaging separately
  5. Note payment method and any financing plan details

Frequently asked questions

Is this dental invoice template free?

Yes. No sign-up, no watermark, no limits. Built for dental practices, orthodontists, and oral surgeons.

What CDT codes are pre-loaded?

The template includes D0120 (exam), D1110 (prophylaxis), D0274 (bitewing), and D1208 (fluoride). Edit with any CDT procedure code.

Can I show insurance and patient portions?

Yes. Add separate line items for insurance estimated coverage and patient responsibility. Show the total patient balance due clearly.

Should I include my NPI number?

Yes. Add your NPI and practice license number to the sender details. This is required for insurance claims processing.

How do I handle payment plans?

Note the financing plan in the invoice terms. Include the down payment, monthly amount, number of payments, and interest rate if applicable.