Dela Rama Dental Online Payment

Patient Online Bill Pay

Please note this portal is only for paying invoices from Dr. Andrew or Marjorie Dela Rama. Any bills from Dr. Bonita, please pay in person at our office.
Name of Patient*

First NameLast Name
Patient Address*

Street Address

Street Address Line 2

CityState

Zip Code
Billing Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Services Provided or Invoice Number *
Enter the services this payment is for, or an Invoice #
Select the office you received services at:*

Millbrae OfficeSouth San Francisco Office
Upon hitting Submit, you will be redirected to our payment platform.

Please note that there is a 3.5% surcharge for credit card payments.

There is no surcharge for Debit card payments. Thank you.
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Patient Online Bill Pay