Dentist Invoice Template for Pennsylvania

Free dentist invoice template for Pennsylvania: PA sales tax 6.00% (services usually exempt), late fees capped at 1.5%/mo under 41 Pa. Cons. Stat. §201, written contracts required over $5,000. Edit, send by email, or download as PDF.

State sales tax
6%
Late fee cap
1.5%/mo
Pre-filled lines
4
Cost
Free
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Pennsylvania compliance baked into the template

  • Sales tax: 6.00% state rate. Generally exempts most services. State 6%; Allegheny +1%, Philadelphia +2%. Many services exempt.
  • Late fees: Up to 1.5% per month under 41 Pa. Cons. Stat. §201. Statutory rate 6%/yr; contract rates allowed in writing.
  • Written contract: Required for jobs over $5,000. The template includes a signature block and scope-of-work field.

Dentist invoice fields

  • Cleaning + exam — flat, default $220
  • Restorative procedure — flat
  • X-ray series — flat, default $165
  • Insurance write-off — flat
State
PA
Avg invoice
$850
Net terms
30 days
Deposit
25%

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