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Greg J. Herd a Dental Corp 30212 Tomas Suite 330 Rancho Santa Margarita CA 92688 Dental Materials Fact Sheet We are required by law to offer you a Dental Materials Fact Sheet. Giving this office your consent to use and disclose health information about you for treatment payment and healthcare operation purposes. Signature Patient Name Patient Representative if minor Date Witness Notice of Privacy Practices This notice describes how health information about you may be used and disclosed and...

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