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First Impressions Dentistry Referrals

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First Impressions Dentistry Referral

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Patient Information

Patient's Name*
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Referring Doctor Information

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Procedures

Extractions*
Full Mouth Implants*
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Bone Grafting*
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Extracting Information

tooth number chart

Radiographs or Clinical photos

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Case Notes

Locations

First Impressions Dentistry of Oklahoma City, conveniently located in Oklahoma City proper
First Impressions Dentistry of Oklahoma City

4235 Northwest Expy
Oklahoma City, OK 73116

405-879-0000

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First Impressions Dentistry Yukon, conveniently located in Yukon, Oklahoma
First Impressions Dentistry of Yukon

1401 S Ranchwood Blvd #110
Yukon, OK 73099

405-354-4806

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