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LAB USE ONLY125B Lamont Drive, Greenville, NC 27858 Telephone: (252) 7561668 Toll Free: (877) 7561668 Email: smiles greenvilledentallab.com WWW.GREENVILLEDENTALLAB. Comfort Order No.: ___ Date: ___

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Greenville Dental Lab Dental is a form used to report dental services provided by Greenville Dental Lab.

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Dentists and dental practices are required to file Greenville Dental Lab Dental.

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The purpose of Greenville Dental Lab Dental is to accurately report dental services provided by Greenville Dental Lab for tax and record-keeping purposes.

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Information such as the type of dental services provided, dates of service, and amount charged must be reported on Greenville Dental Lab Dental.

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