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Levy Dermatology, P.C. 6254 Poplar Avenue Memphis, TN 38119 P: (901) 6243333 F: (901) 6241203 Please print and answer all questions in full. First Name: ___ Middle Initial: ___ Last Name: ___ Address:
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What is dr alan l levy?
Dr. Alan L. Levy is a dentist specializing in orthodontics.
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Dr. Alan L. Levy or any individual or entity that has received services from him.
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The purpose of Dr. Alan L. Levy form is to report payments made for orthodontic services.
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The information that must be reported on Dr. Alan L. Levy form includes the name of the individual receiving services, the date of service, and the amount paid.
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