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Online Referral
We value our referring dental partners! You may refer patients to our office by filling out our secure online referral form. 
Upon submission, the patient will receive an email confirming their referral. We will follow up with the patient to schedule their appointment.

Reason for referral Required
Recent Treatment
Treatment Requested Required
Place the following restoration
Upload File
Upload x-rays (Max 15MB)
Upload File
Upload x-rays (Max 15MB)

Thank you for the referral!

1932 University Ave W, St Paul, MN 55104

office@thedentalclinicmn.com

Tel: (612) 444-1949

Fax: (612) 445-5477

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