Register new patient?

You are very welcome at the Hollands Spoor dental practice.
Please fill out the registration form below.
Once we have received your personal information, we will contact you to make an initial consultation and introductory meeting.

Registration form

Preference for a dentist
Surname *
Initials
Firstname
Gender
Date of birth
Address *
Postal code *
City *
Phone number*
Your Insurance company *
Insurance Policy Number *
Email address *
Name current dentist
Year last visit dentist *
Reason for leaving current dentist
How did you find us?

I agree with the Privacy Statement.

Tandartsenpraktijk Den Haag

First appointment

Please bring your ID when you come to our practice. You will also need to fill out a one-time medical questionnaire. If you are taking any medication, would you please list the name and dosage?

Recent X-rays are necessary to get a good impression of your teeth. If these X-rays are older than two years, of poor quality or missing, they will be redone. In some cases it is necessary to make an additional X-ray of a specific area. You will be informed in advance if this is the case. After the initial consultation, you will have become a patient in our practice.

Contact Information ▼

Dental Practice Hollands Spoor
Stationsweg 107 1st floor
2515BL The Hague

Dentist P. Grewe (070) 3800910
Dentist C.W. Lely (070) 3803100
Dentist D.R. Kösters (070) 3802891

info@tandartsenpraktijk-denhaag.nl

Opening Hours ▼

Dentist P. Grewe
Monday to Thursday 8.30 – 17.00
appointment | register

Dentist Willem Lely
Monday to Thursday 8.30 – 17.00
appointment | register

Dentist Derk Kösters
Monday to Thursday 8.30 – 17.00
appointment | register