Anthony P. Urbanek
D.D.S. M.D
Celebrating over 28 Years
Serving Middle Tennessee
Oral Surgeon Brentwood, Franklin, Nashville TN

Celebrating Over 20 Years of Quality Medical & Surgical Care
Online Doctor Referral

Referring Doctors and Dentists

This section is for doctors only. If you are a patient please return to our Contact Us page by clicking (here).

Welcome to our Doctors Only section. It's our goal to create a lasting and mutually beneficial relationship with our referring doctors and dentists. To help facilitate the referral relationship, we have installed a convenient referral form that can be filled out and sent along with any digital x-rays by completing the form below.

Doctor Referral Form


Date:
Time:
First Name:
Last Name:
Referred By:
Telephone:
Email:

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Please Verify Tooth #s:

 

OTHER PROCEDURES
CONSULTATION
RADIOGRAPHS
Alveoplasty TMJ
Biopsy Implants
Incision and Drainage Orthognathic Evaluation
Lesion Evaluation Pre-Prosthetic
Exposure Cleft Lip and Palate
Hard Tissue Cosmetic
Infection Other
Expose and Bond
IMPLANTS
Soft Tissue
Frenectomy
SURGICAL TEMPLATE

 

Please include digital radiograph by pressing the browse button and locating the image on your hard drive:

COMMENTS

 

Removal of Wisdom Teeth  Dental Implants  TMJ Disorders  Snoring and Sleep Apnea  Cleft Palate  Cleft Lip  Facial Nerve Reconstruction   Corrective Jaw Reconstruction  Oral Pathology  Oral Cancer and Brush Biopsy  

Dr. Urbanek Oral Surgeon serving Brentwood, Franklin, Nashville and Middle Tennessee for over 28 years
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