|
D. Garlan Ceramics
Exceptional Quality, Superior Service |
|
| Daniel Garlan Downie CDT President 7238 S. Tyler Tacoma, Wa. 98409 |
Phone: (253) 475-7730
Cell: (253) 381-8835 Fax: (253) 475-2339 |
| Patient name: | Date: |
| Special Instructions | |
| Shade: | |
| Finish Date: | Hour: |
| DR. Signature: | |
| Phone #: | |