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Records Request From Previous Provider
First Name
Last Name
Date Of Birth
I,
request for
's office to send copies of any x-rays that are less than five years old and dental records to
the office of
Spruce Pine Dental Arts
Dr. Emily Wheeler Maltba, DMD
54 Broad Street
Spruce Pine, NC 28777
828.765.7383
or email:
info@sprucepinesmiles.com
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