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About Dr. Billy
Treatments
Tongue-Tie & Lip-Tie Interventions
Airway-Focused Orthodontics
Growth & Development Guidance
Concierge Pediatric Dentistry
Prenatal Visits
Patient Resources
New Patients
Patient Education
Referrals
Home
About Dr. Billy
Treatments
Tongue-Tie & Lip-Tie Interventions
Airway-Focused Orthodontics
Growth & Development Guidance
Concierge Pediatric Dentistry
Prenatal Visits
Patient Resources
New Patients
Patient Education
Referrals
Start Appointment
Contact
Home
About Dr. Billy
Treatments
Tongue-Tie & Lip-Tie Interventions
Airway-Focused Orthodontics
Growth & Development Guidance
Concierge Pediatric Dentistry
Prenatal Visits
Patient Resources
New Patients
Patient Education
Referrals
Home
About Dr. Billy
Treatments
Tongue-Tie & Lip-Tie Interventions
Airway-Focused Orthodontics
Growth & Development Guidance
Concierge Pediatric Dentistry
Prenatal Visits
Patient Resources
New Patients
Patient Education
Referrals
Schedule Now
Patient Referral Form
If you suspect your patient has a tongue tie and would like to refer
them for a consultation, please fill out the form below.
Patient’s First and Last Name
Date of Your Last Appointment with This Patient
Your Name
Your Email Address
Your Assessment
Submit Referral
Your Child Deserves to Breathe, Sleep, and Thrive.
Let’s Make a Plan Together.
Submit
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