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Dr. Name Phone # Acct. # Patient Name (First) (Last) Address×Email Deliver by 5 p.m. on See Reverse for Working Times 8880 NW 20th St. Ste. C, FL 33172 8883361301 Fax 8883366006 www.digitechlab.com
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All restorations are made in a specific restoration form.
All individuals or entities required to file all restorations made in.
All restorations can be filled out online or on paper form with accurate information.
The purpose of all restorations is to accurately report any changes or modifications made.
All relevant information about the restoration must be reported, such as date, location, and nature of the restoration.
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