Opendatum

Locations
5252 Sunrise Blvd., Suite #2, Fair Oaks
255 West Court St., Building A, Suite #1, Woodland
1215 Plumas St Suite 300, Yuba City
Phone: (916) 454-0860

FOR DOCTOR USE ONLY

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Implant Type Request

None Astra BioHorizon Biomet 3i Implant Direct Implant Innovations KeystoneLifecore MIS Nobel BioCare Straumann Zimmer

Imaging

No Imaging Attached Mailed With Patient

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Patient's chief complaint and expectations*