Eric Blasingame DDS, MS
Board Certified Periodontist
William Liska DDS
Board Eligible Periodontist
teamperiodontics.com
Redding 530.241.3302
Reno 775.447.1191
1
Patient Information
Imaging Provided


2
Evaluation For
icon tooth/gum
icon tooth
icon implants
icon microscope
icon checkmark

If you need help with this form or want to see if your patient can be seen the same day, please call our office.
Redding: 530.241.3302 | Reno: 775.447.1191

Redding

384 Hartnell Ave. Suite A.
Redding CA 96002

Phone: 530.241.3302

Reno

855 West 7th St. #130
Reno NV, 89503

Phone: 775.447.1191