DR. SHANE T. CLARK Referral Form€¦ · ROOT CANAL Dr. Clark will make sure your root canal is...
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Name ________________________________________ Date Referred ___________________________________ Referred by Dr. __________________________________ Tooth Area _____________________________________ ____ Evaluation ____ 3D Conebeam Scan ____ Root Canal ____ Apical Surgery ____ Retreatment ____Other ______________________________________________ ____ Final Restoration ____ Temporary Filling ____ Permanent Filling ____ Post Space ____ Post & Core ____ Core Buildup Beautiful view. Beautiful experience. DR. SHANE T. CLARK Referral Form We can always see your emergencies the same day and finish your patients in a timely manner. Please bring referral to appointment. Nominated “Top Endodontist” – ABQ The Mag
Transcript of DR. SHANE T. CLARK Referral Form€¦ · ROOT CANAL Dr. Clark will make sure your root canal is...
Name ________________________________________
Date Referred ___________________________________
Referred by Dr. __________________________________
Tooth Area _____________________________________
____ Evaluation ____ 3D Conebeam Scan ____ Root Canal
____ Apical Surgery ____ Retreatment
____Other ______________________________________________
____ Final Restoration ____ Temporary Filling ____ Permanent Filling
____ Post Space ____ Post & Core ____ Core Buildup
Beautiful view. Beautiful experience.
DR. SHANE T. CLARKReferral Form
We can always see your emergencies the same day and finish your patients in a timely manner.
Please bring referral to appointment.
Nominated “Top Endodontist” – ABQ The Mag
Dr. Chuck Goodis has dedicated his career to constantly improving the root canal procedure. Using the most advanced anesthetics for root canal treatment we achieve complete numbing before we begin. In addition, our advanced instruments and procedures enable us to complete your root canal quickly and painlessly.
MONTGOMERY BLVD
PENN
SYLVAN
IA N
E
Compass Bank
Building C
Building DBuilding ERoot Canal Specialists
PennMont Plaza
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Gentle Care is Our Specialty
Dr. Clark was born and raised in Albuquerque, NM. He obtained his undergraduate degree in Biology from St. Edwards University in Austin, TX. Dr. Clark then received his D.M.D from the Arizona School of Dentistry & Oral Health where he also met his beautiful wife Margo, who is a general dentist. Dr. Clark’s passion for root canals lead him to the University of Missouri Kansas-City where he completed a two year Endodontic residency. Dr. Clark and his wife enjoy raising their two children, Colton & Presley, staying active, expanding their dental knowledge, and helping the community.
Dr. Shane T. Clark, DMD
R O O T C A N A LDr. Clark will make sure your root canal is easy, simple and painless. After your root canal, you will return to your general dentist for a permanent restoration, crown or filling and the tooth will function like normal.
E A S YWe respect our patient’s time, with the procedure itself taking usually less than 60 minutes. In most cases you can go back to work and continue your day.
S I M P L EWith our serene office environment and experienced staff, we will do everything possible to make your visit simple and relaxing.
PA I N L E S SWe make sure our root canals are painless by using the most advanced anesthetics.
7520 Montgomery Blvd. NE, Ste E-1 Albuquerque, NM 87109
t: 505.797.1212 f: 505.823.1831nowpainless.com
