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W I L L I A M J. C L A I BO R N E, Specialist in PeriodonticsDDSBiltmore Periodontics William J. Claiborne, DDS 11 Yorkshire Street, Asheville, NC 28803A. Patient Name B. Authorization of release

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1. Gather all necessary information such as patient details, treatment provided, and any additional charges.
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4. Provide a detailed description of the medical services provided, including the date, time, and duration of each service.
5. Include any additional charges for medications, supplies, or procedures performed.
6. Double-check the accuracy of all information and calculations before submitting the bill.
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8. Keep copies of all documents and receipts for your records.

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