Interstate Dental Clinic Recall Appointment Request Form for Dentures in the Portland OR area.

	Recare/Recall Appointments Call For An Appointment Now! (503) 285-5307 For Current Patients of Interstate Dental Clinic Please provide us with the following contact information. We will contact you shortly to schedule an appointment at Interstate Dental Clinic. If this is a dental emergency, please call (503) 285-5307 or dial 911. Title: First name: Middle initial: Last name: I like to be called: (Sample: Mrs. Jones or Jennie) Email: Work or cell phone: *Home phone: Fax: Call me: The best time is: Do you have an immediate concern? Would you like to subscribe to our newsletter? Our email policy - We promise never to sell, barter or rent your email address to any unauthorized party. Please be aware that the information above will be sent via email. Financial Arrangements Our goal is not to let expense prevent you from benefiting from the quality of care you desire and need.	Appointments: (503) 285-5307 Interstate Dental Clinic 5835 N Interstate Ave Portland, OR 97217 General Info: (503) 285-5307
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