Referral Form for Dentists

Scott A. Reef, DDS, MSD and Justin J. Villanueva, DMD, MSD, DHL – Periodontal Associates of Lafayette

We strive to provide the highest quality state-of-the-art dental therapy, while individualizing treatment to each patient’s needs. Call us Today!
Click To Call
765-447-9319
Schedule Your
Appointment
Patient
Registration

Our Office Hours: Monday - Wednesday 8:00 AM - 5:00 PM, Thursday 8:00 AM - 3:00 PM, Friday 8:00 AM - 12:00 PM

Please forward this printable referral form to  us when sending one of your patients our way.  As always thank you for your referral.