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Integrated Endodontics PLLC
Wilson Duong, DDS
Marie Kwok, DDS
Specialist in Endodontics and Microsurgery
355 Ovington Ave, STE 200
Brooklyn, NY 11209
718-833-2880
info@iendony.com
Please fill out the form below to refer a patient to our office. After submitting the form, you will be able to save a summary of the referral and directions to our office.
*Required Fields
Patient Information
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First Name
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Last Name
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Date of Birth
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Email
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Phone
Referring Doctor Information
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First Name
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Last Name
Email
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Phone
Teeth Needing Treatment
Teeth Needing Treatment
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Requested Treatment
Consultation
Root Canal Therapy
Root Canal Retreatment
Apicoectomy Surgery
Post Space Preparation
Restoration
Temporary
Composite
Attach Files
Referral Notes
Integrated Endodontics
355 Ovington Avenue, Suite 200
Brooklyn, NY 11209
Phone:
(718) 833-2880
www.iendony.com
