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Doctor Referral Form

Please complete and print out our Patient Referral Form, then fax this referral to the appropriate office. Thank you!

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Pediatric Dentists Dr. Thomas, Dr. Hawkinson & Dr. Lopez provide Children's Dentistry
including orthodontic treatments, cavity prevention, gum disease prevention, thumb sucking
and tooth brushing tips to Leawood, Lee's Summit, Kansas City North & the Country Club Plaza.
Orthodontist Dr. Crist provides orthodontic treatment to Leawood.

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