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Implant Referral

  • Dentist information

  • Patient information

    • Email:
    • Post:

Treatment information

    • Consultation only
    • Treatment
    • Bad taste:
    • Bleeding:
    • Difficulty chewing:
    • Pain:
    • Recurrent abscesses:
    • Swelling:
    • Tooth mobility:
    • Yes:
    • No:

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