Dentist Referral Form

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    Dentist Referral Form

    Thank you for considering Palo Alto Orthodontics as a solution for your patient’s orthodontic needs. We look forward to partnering with you to help them achieve a healthy, functional smile. Please fill out the online form to submit your referral, or you can download and print the referral form here. If you have any questions, don’t hesitate to contact us at (650) 327-2310.

    Contact Info

    Current Patient: 650-327-2310

    New Patient: 650-844-0638

    Email: smile@paloaltoorthodontics.com

    Fax: 650-999-0710

    Address:
    905 Middlefield Rd, Suite A
    Palo Alto, CA 94301

    Hours:
    Monday-Thursday: 8:00 a.m. – 5:00 p.m.
    Friday: By appointment only