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THOMPSON DENTAL GROUP Donna M. Thompson, D.D.S., P.C. Jennifer L. Thompson, D.D.S. 1212 E. 20th St. Farmington, NM 87401 Tel (505) 3276233 Fax (505) 3246442Financial Agreement / Signature on File

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Information such as financial terms, payment schedules, and any other relevant financial details must be reported on the financial agreement sof ampamp.

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