Referring Doctors

The referral form below is provided for our referring doctors. For your convenience, this form can be printed, filled out and given to the patient or mailed to our office prior to the patient's first visit with us. Thank you for your referrals and your expression of confidence in our office.

 

For your convenience, our Referral Form is available for download here in Adobe Acrobat PDF format. The Adobe Acrobat Reader is FREE and can be downloaded by clicking on the icon below.

Referring Doctors

Terence R. Dentkos, DDS, MS

Phone: (440) 268-8445, Fax: (440) 268-8443
Email: dentkosendo@wowway.biz
16626 Pearl Rd
Strongsville, OH 44136