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  Saturday September 04. 2010   Acknowledgment of Receipt Dental Materials Fact Sheet Health History Notice of Privacy Practices





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Health History
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Acknowledgment of Receipt of Notices Form. Please print out and sign to bring to the office upon your visit.

 


 
Dr. John M. Moffat, D.D.S.
23111 Ventura Blvd., #102
Woodland Hills, CA 91364
Phone: (818) 225-0041
johnmoffatdds@sbcglobal.net

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