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Wenatchee Dental 808 N. Miller Street Wenatchee, WA 98801 ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICE MAY REFUSE TO SIGN THIS ACKNOWLEDGEMENT have received a copy of these offices Notice
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It is a form that needs to be filed for dental services provided in Wenatchee, Washington.
Dental service providers in Wenatchee, Washington are required to file this form.
You can fill out the form by providing details of the dental services provided and the necessary information requested.
The purpose of this form is to report dental services provided in Wenatchee, Washington.
Information such as the type of dental services provided, dates of service, and amounts charged must be reported.
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