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Hi,

Customer/Point of Contact:

Future Smiles Orthodontics
Dr. Paul Sauget DDS, MSD (671-648-9888)

Scheduled Date/Time:

06/15/2020, 04:30 pm

Service Type:

Onsite

Charge Type:

Normal

Charge Code:

DSIG.4055: Standard Service 2020

Rates:

Standard Service Rate 2020 [TOTAL ANNUAL HOURS: 2]

Remaining Hours:

Est. Service Time (hrs):

Reference/PO #:

Taken By:

Melissa Dimla

Customer Signature:

Yes

Print Name:

Audrey

Date Signed:

06/15/2020

Invoice Number:

029060

Check on Dr Paul's phone

Work Requested by: Dr. Paul Sauget DDS, MSD

Work Completed :

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