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(630) 296-9297
Our Practice
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General Dentistry
Dental Implants
Invisalign Orthodontics
Root Canals
Cosmetic Dentistry
Restorative Dentistry
Periodontal Therapy
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Virtual Smile Consultation
Referral Form
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Chinese Speaking Dentist
Contact Us
Menu
Our Practice
Meet Dr. Heng Xu
Our Team
What Sets Us Apart
Your First Visit
Office Events
Tour Practice
Services
General Dentistry
Dental Implants
Invisalign Orthodontics
Root Canals
Cosmetic Dentistry
Restorative Dentistry
Periodontal Therapy
Teeth Whitening
Dental Hygiene
Dental X-Rays
Mouthguards
Emergency Dental services
Patient Resources
Request Appointment
Smile Gallery
Patient Resources
Payments
Refer A Friend
Virtual Smile Consultation
Referral Form
Blog
Chinese Speaking Dentist
Contact Us
BOOK MY APPOINTMENT
Referral Form
General Referral
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Patient Name:
*
DOB
*
Phone
*
Layout
Referrieng Office:
Doctor/Hygienist
Teeth you are having the issue with
*
Teeth you are having the issue with
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Reason For Referral:
*
Implant Placement
Implant Restoration
Premolar/Molor Root Canal
Complex Extraction(Wisdom teeth)
Apicoectomy Surgery/Frenum Attachment Surgery
Crown Lengthening
CBCT
Free Second Opinion
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