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MEDICALDENTAL HISTORY Name (Dr., Mr., Ms., Mrs.): Address:___What should we call you?______Date of birth:______Age:___Home Phone:___Occupation:___Cell Phone:__Employer:__Work Phone:__EMail:__Referred
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What is the name of the previous dentist?
The name of the previous dentist is the full name of the dental professional who provided your dental care prior to your current dentist.
Who is required to file the name of the previous dentist?
Patients receiving dental care may be required to file the name of their previous dentist as part of their medical history or insurance claims.
How to fill out the name of the previous dentist?
Fill out the form by writing the full name of your previous dentist, including any titles or certifications, and the address of their practice if required.
What is the purpose of the name of the previous dentist?
The purpose is to provide a comprehensive medical history, ensuring continuity of care and assisting in treatment planning.
What information must be reported on the name of the previous dentist?
Typically, the information required includes the dentist's full name, practice address, and contact information.
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