Patient Referral From

Patient Details

Referring Clinician's Details

Clinical Details

Core Required
Tooth or Teeth needing attention (please state number )
Please email any relevant clinical photos or radiographs to
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Brighton Endodontics

21 Black Street, Brighton, Victoria 3186

For appointments & cancellations:
Telephone 03 9593 2466

Dr. Luke Moloney is available for endodontic consultations

Get Directions
Bendigo Dental Specialists

113 Forest Street, Bendigo 3550

For appointments & cancellations:
Telephone 03 5442 6666

Dr Artika Soma available for endodontic consultations.

Get Directions