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Services
Periodontal
Dental Implants
Orthodontic Supportive
Maintenance
Patient info
Patient Registration
Care Instruction
Referring Dr
CE Courses
Hygiene Study club
Doctors Study Club
Join our Team
Contact Us
Home
About Us
Services
Periodontal
Dental Implants
Orthodontic Supportive
Maintenance
Patient info
Patient Registration
Care Instruction
Referring Dr
CE Courses
Hygiene Study club
Doctors Study Club
Join our Team
Contact Us
Home
About Us
Services
Periodontal
Dental Implants
Orthodontic Supportive
Maintenance
Patient info
Patient Registration
Care Instruction
Referring Dr
CE Courses
Hygiene Study club
Doctors Study Club
Join our Team
Contact Us
Request Appointment
form referring
Home
/
form referring
Download Referral Forms
Drs
*
Sarmad Paydar, DDS MS
Kyu Jin Lee, DDS, MSD
Gordon Douglass, DDS
James Zaiger, DDS, MS
First Available
Preferred Location
*
Falsom
Roseville
Sacramento
Introducing
Date
From Dr
Patient Phone
PERIODONTAL CONCERN
Complete Periodontal Examination
Limited Periodontal Evaluation
Crown Lengthening(s)
Extraction(s)
Recession(s)
Frenectomy
Implant(s)
Extraction(s)
Bone Graft
Peri-implantitis
Biopsy
Other
Special Instructions or Comments
HYGIENE/PERIODONTAL MAINTENANCE
Periodontist
Alternating
Referring Dentist
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