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Dr. Marcus Hannah & Dr. Anna Truing 970 N. Palace Avenue Ste A305 pH: (808)2545454 Fax: (808)2545427 Email: smile@kailuadentalarts.com Date: ___Patient Name (First/Last): ___ Preferred: ___ Gender:
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Dr. Marcus A. Hannah requires reporting of income, deductions, credits, and other financial information as instructed by the IRS.
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