Page 84 - Appendices for Eric Hartman
P. 84

COMPREHENSIVE DENTAL

   Care to maintain or treat problems with your teeth and gums.





       Non-routine services                   Not covered




       Diagnostic services                    Not covered





       Restorative services                   Not covered




       Endodontics                            Not covered





       Periodontics                           Not covered




       Extractions                            Not covered





       Prosthodontics, other                  Not covered
       oral/maxillofacial surgery,
       & other services
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