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Elizabeth P. Glad nick, DMD Thomas B. Glad nick, DMD Monica P. Par ham, DDS 15215 Shady Grove Rd. Suite 103 Rockville, MD 20850 3019630800Authorization for Release of Dental Records To: Previous Dentists
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What is previous dentists name?
The previous dentist's name is the name of the dentist who provided dental services to the patient before their current dentist.
Who is required to file previous dentists name?
The patient or their current dentist is required to file the previous dentist's name.
How to fill out previous dentists name?
The previous dentist's name can be filled out on the patient's dental record form or provided to the current dentist verbally.
What is the purpose of previous dentists name?
The purpose of providing the previous dentist's name is to track the patient's dental history and ensure continuity of care.
What information must be reported on previous dentists name?
The information that must be reported includes the previous dentist's full name, practice name, and contact information.
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