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ACE DNTL STUDIO

Aesthetic Dental Studio · Marbella · Estepona · Riviera · acedntl.com

Documentation for Försäkringskassan

Dental care in another EU/EEA country

Patient
Personal ID no.
Treating dentistDr. Arsalan Korkchi, licensed dentist
Clinic (country of care: Spain, EU)ACE DNTL STUDIO, Marbella
Place and dateMarbella, 19 June 2026

This documentation concerns dental care received by the patient from a provider in another EU/EEA country, submitted in support of an application for reimbursement under the rules for cross-border care.

Patient and background

The patient has been treated at ACE DNTL STUDIO, Marbella, a licensed dental practice in Spain within the EU. The treatment was carried out by a licensed dentist and documented in the patient's clinical record.

Diagnosis and medical need

The diagnosis and underlying medical need are set out in the patient's clinical record. The treatment was assessed as warranted in light of the clinical condition found at examination.

Treatment performed

The procedures performed are itemised in the patient's clinical record and in the invoice accompanying this documentation.

Cost

Total treatment costto be completed

The amount represents the total cost of the dental care provided. An itemised invoice with proof of payment is enclosed and forms the basis for the amount stated above.

Dr. Arsalan Korkchi

Licensed dentist

ACE DNTL STUDIO, Marbella

Reg. no. / Nº colegiado

Clinic stamp

Marbella · España · acedntl.com

This documentation is issued at the patient's request for submission to Försäkringskassan when applying for reimbursement of cross-border (EU/EEA) dental care.