oral + maxillofacial surgery

CLOSE TO HOME.

Your patient’s full-service smile care is our number one priority! We are thrilled to offer oral surgery services with immediate availability, so your patient can get back to their regular smile routine.

Feel free to reach out with any questions or concerns – we greatly appreciate your referral and trust in our oral surgeon.

SERVICES CURRENTLY AVAILABLE FOR REFERRAL:

ROUTINE + COMPLEX EXTRACTIONS
IMPACTIONS
IMPLANTS + MISSING TEETH

OFFICE LOCATION:

WAUSAU • 715.842.4649
413 N 17TH AVE, WAUSAU, WI 54401

our team is ready

To help

If you have questions, we can help.

This is a secure form.

Thank You.

Patient's Full Name

Date of Birth

Guardian's Full Name

Patient's Primary Phone Number

Primary Email Address

Primary Home Address

Choose Nearest Office Location for Referral

Wausau

Referring For The Following Treatment:

Extractions Impactions Missing Teeth + Implants Please Have Your Providing Doctor Call Our Office Before Seeing This Patient

Additional Comments

Imaging

Please Attach Panorex Here

Office Contact Information

Office Email

Office Phone

First Impressions Pediatric Dentistry & Orthodontics

oral + maxillofacial surgery

CLOSE TO HOME.

SERVICES CURRENTLY AVAILABLE FOR REFERRAL:

OFFICE LOCATION:

our team is ready

To help

If you have questions, we can help.

This is a secure form.

Thank You.

refer a patient

smile makers

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