The above-named dentist/dental center may use my health care information and may disclose such information to the above-named Insurance Company(ies) and their agents for the purpose of obtaining payment for services and determining insurance benefits or the benefits payable for related services. This consent will end when my current treatment plan is completed or one year from the date signed below.
Barbiturates (Sleeping Pills)
7:30am – 5pm Mon.
7:30am – 5pm Tue.
7:30am – 5pm Wed.
7:30am – 5pm Thu.
Waterville Community Dental Center
2 Evergreen DriveOakland, ME 04963
(207) 861-5801Email Us