Online Referral Form- for Dentists and PCP’s

Welcome Referring Dentists

To our referring dentists, we want to extend our warmest thanks.

At Central New Hampshire Oral Surgery in Concord NH, we value our relationships with referring dental practices and are proud to partner with you in providing excellent oral healthcare to our community. Your choice to put the care of your patients in our hands is the highest compliment our practice could receive. We have found that patients appreciate dental offices that partner with trusted specialists for complex procedures – it helps to build trust and loyalty in both practices.

To achieve a high level of trust with our shared patients, we:

  • Review cases thoroughly in advance
  • Refer back to your office for restorations
  • Collaborate with you on treatment plans
  • Are available in an advisory role if requested
  • Offer accommodating scheduling
  • Provide timely assessments and imaging

If you have any questions about our practice, please feel free to call us at Central New Hampshire Oral Surgery Phone Number 603-228-9050. Above all, we want to thank you for your referral of our office.

Office Hours

Monday through Friday:   8:30am–5:00pm

Click on the Referral Form. This link will open a pdf copy of our referral form. You may print this form, fill out your patient information and fax it to us: 603-229-0237 ; We will contact your patient within 24 hours to schedule an appointment.

The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it. Please consider transmitting any sensitive information about your patient by calling Dr. Levy personally at: Central New Hampshire Oral Surgery Phone Number 603-228-9050.