Dela Rama Dental Online Payment

Patient Online Bill Pay

Please note this portal is only for paying invoices from Drs. Andrew or Marjorie Dela Rama.
Name of Patient*

First NameLast Name
Patient Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Services Provided or Invoice Number *
Enter the services this payment is for, or an Invoice #
Upon hitting Submit, you will be redirected to our payment platform.

Please note that there is a 3% surcharge for credit card payments.

There is no surcharge for Debit card payments. Thank you.
Select the office you received services at:

Millbrae OfficeSouth San Francisco Office
Billing Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Patient Online Bill Pay