Referral Form


Please use the following form for in-person consults in Atlanta, GA.

If you would like a physical referral pad mailed to your dental office, please call 770-799-6028

For a provider-to-provider virtual consults (DDS/DMD only), please click on the “Virtual Consult Portal” tab on the upper right.

Thank you!!




Contact:

705 Town Boulevard, Suite Q360

Brookhaven, GA 30319

Located within Atlanta Oral and Maxillofacial Surgery & Dental Implant Center

P: 770-799-6028

F: 770-462-5428

info@jawimplant.com