Welcome! The benefits of a happy, healthy smile are immeasurable! Our goal is to help you reach and maintain maximum oral health.
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09/29/2020
Insurance
Medical History
Dental History

Payment is due in full at the time of treatment unless prior arrangements have been made.

Our office is HIPAA Compliant and is committed to meeting or exceeding the standards of infection control mandated by OSHA and the ADA

OFFICE USE ONLY - OFFICE USE ONLY - OFFICE USE ONLY

Medical History Update

and confirmed that it states past and present medical conditions.
and confirmed that it states past and present medical conditions.
and confirmed that it states past and present medical conditions.