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Thomas C. Spalla, MD P:215273FACE (3223) 456 N 5th St. Suite 3 Philadelphia, PA 19123 www.phillyfacialsurgery.comNEW PATIENT INTAKE FORM DEMOGRAPHICS Name: ___ LastFirstAge: ___MiddleDOB:___ SEX:
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Philadelphia facial plastic surgery refers to surgical procedures performed on the face to enhance aesthetic appearance or correct deformities.
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Patients who undergo facial plastic surgery in Philadelphia are required to file their medical records and other relevant documentation.
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