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SMILES BY DESIGN GREG McELROY DDS CONSTANTINE REPPAS DMD OFFICE 760 479-9898 FAX 760 479-0053 EMAIL office drmcelroy. I acknowledge that upon my request I may receive a copy of the Dental Materials Fact Sheet adopted by the Dental Board of California dated October 2001. Com WEBSITE drmcelroy. com Patient Information Patient Name First MI Last Preferred Name Date Gender Male / Female Marital Status Email Birth Date Social Security Work Phone Home Address Cell Ext Street Apartment City State...
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