Authorization and Request for Previous Dental Records and Radiographs

Authorization and Request for Previous Dental Records and Radiographs

Please forward any previous x-rays and/or records as soon as possible to:
Nicollet Station Dental
510 Marquette Ave. S.
Minneapolis, MN 55402
info@nicolletstationdental.com
612-338-5557
Fax: 612-373-0602