Oral Surgery Referrals | Children's Dental Health

Oral Surgery Referrals

Children’s Dental Health is excited to offer oral surgery at our Bethlehem location. We are accepting referrals from neighboring health providers for teens and adults.

Your patients will be treated with the utmost level of care from our board-certified oral surgeons in Bethlehem. We accept most insurances, CHIP, and Medicaid. Please submit the form below to refer your patients to us. Thank you!

oral surgery Bethlehem patient

CDH Oral Surgery Referral

Patient Information

Name(Required)

First Last

Patient Email(Required)

Patient Phone(Required)

Patient Date of Birth(Required)

Patient Insurance(Required)

Insurance Group or ID(Required)

Provider Information

Referred By (Practice or Provider Name)(Required)

Provider Address(Required)

Provider Email(Required)

Chief Concerns

Chief Concerns(Required)

Wisdom Teeth

Premolars

Extractions

Others

Notes & Comments

Please note any additional concerns or notes for this referral.

In-Network With Most Insurances, CHIP, & Medicaid

UPMC insurance icon