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Meet the Doctor
Dr. Bennett Galperin
Welcome to Our Office
Smile Transformation
Clear Aligners
Invisalign
Spark Clear Aligners
Braces
Children
Adults & Teens
RETAINER GUARANTEE™
For Patients
For Doctors
Refer a Patient
Referring Doctor’s Name *
Your Referring Doctor’s Name is required.
Patient’s Name *
Your Patient’s Name is required.
Patient’s Email Address *
Please input a valid Patient’s Email
Patient’s Phone Number *
Please input a valid number
Reason(s) for Referral
Evaluate for Interceptive (Phase I) Treatment
Evaluate for Orthodontics
Evaluate for Orthodontic Surgery
Other
Please input reason(s) for referral.
Special Requests
Please Call Before Treating
Radiographs Have Been Sent After Seeing Patient
Please check Special Requests.
Preferred Office Location
Wethersfield
Middletown
Please input preferred office location.
Relevant Files
Your Relevant Files is required.
Main Concerns
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