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Make a dental referral

Our referral form

Here at Bristol Endodontic Clinic we accept referrals from dental professionals and also self-referral’s from patients of all ages. You can download our referral form and send it to us. We will contact you to confirm your referral. You can also use our online referral form.

  • Make a secure private referral online
  • Referral Form - Bristol Endodontic 507

You can post the completed referral form to us:

Bristol Endodontic Clinic
9 North View,
Bristol,
BS6 7PT

Or you can email the completed form to: [email protected]

If you need any help with our referral form you can speak to us on 0117 923 8400.

Our clinicians overview

  • Mr.Simon Martin Qualified from: MB. ChB BDS (University OF Bristol) FDS. RCS [England] United Kingdom, 1987 GDC No: 62618
  • Dr.Bindhu Mary Koshy Qualified from: BDS, MFDSRCS(Eng), MClinDent(Perio)Lon, MPhil(CU), FHEA Mangalore , 1994 GDC No: 83910

Read more about our clinicians here

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All content and images © 2025 mydentist. mydentist is a trading style of mydentist Group Limited whose Registered Office is at: Europa House, Europa Trading Estate, Stoneclough Road, Kearsley, Manchester, M26 1GG Whose Registered No is: 05657369. mydentist Group Limited as above is a member of the mydentist group. 

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working with:

Care quality commission
Healthcare Inspectorate Wales
RoSPA Gold Award 2023
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