Make an Appointment Today!

Call us at: 201 2221123

 

Pourang Bral, DDS, LLC

901 bergen ave

jersey city, NJ 07306

Fax:

Email: drpbral@gmail.com

 

Use our contact form to get in touch.

Office Hours

 

 

Outside our regular business hours, please note our emergency care information.

Keep Your Teeth Healthy!

What is the best preventive care for your teeth? Find out how to make your next visit easier and more pleasant.

Get Social With Us

Patient Forms

New patient? Please download and fill out the following forms when you come in for your first appointment.

Patient Medical History Form

This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.

Patient Medical History Form
Medical Hx.doc
Microsoft Word document [38.0 KB]

Privacy Notice

Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy. This form should also be brought to your first appointment.

Privacy Notice
This is some information you should know if we are processing your insurance forms for you. Please Read And Sign the 3rd page and bring to the office at your first appointment. If you forgot to bring
Hippa Notice Consent.odt
Open Office Writer [12.8 KB]
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