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Pacific Northwest Oral & Maxillofacial Surgeons

Auburn
309 2nd St
Auburn, WA 98002
Phone: (253) 929-8711


Federal Way
2345 SW 320th St
Federal Way, WA 98023
Phone: (253) 838-2123


Renton
601 South Carr Rd
Renton, WA 98055
Phone: (425) 277-1844


Maple Valley
26808 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038
Phone: (425) 432-1511


Puyallup
8012 112th St CT E, Suite 260
Puyallup, WA 98373
Phone: (253) 770-1000


Burien
275 SW 160th St, Suite #115
Burien, WA 98166
Phone: (206) 703-2410


SeamlessDocs

Please Take
Tooth
Tooth
Ben R Johnson DMD
Given to Patient
Emailed to
Mailed PA or PANO
Date Taken
Implants please mark tooth areas on the chart below
ezPRO
Tissue Former
INOL
Fixture Level
Intraoral Scan
Tooth Extractions please mark tooth areas on the chart below
Oral Biopsy/Pathology
Trauma/Injury
Other/Comments Remarks or Special Instructions
Primary Tooth
H. Sean Moon DDS MD
Sohaib H Soliman DDS
Kevin Huang, DDS, MD
Michael Baily, DMD
x

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