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Provider Referral to
Open and Affordable Dental and Braces

Please use this form to refer to Open and Affordable Dental and Braces.  We have Oral Surgeons, Orthodontists, and Endodontists we work with who would be more than happy to see your patients on a limited or permanent basis.  We have extended hours on evenings and weekends and are in-network for almost all insurance companies.
OS Procedures
Reports Pain On
Does the Patient Have Insurance Coverage?
Upper Teeth
Lower Teeth
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If transferring patients between Open and Affordable Dental and Braces offices, please include the patient's New Patient Forms, and X-rays using the buttons above.

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