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Periodontic Clinic
446 Dental Science Building South
Iowa City, IA  52242-1001
319-335-7232
319-335-7233
Fax: 319-335-7239


FACULTY PRACTICE  
  • Gustavo Avila-Ortiz, DDS, MS, PhD   Bio
  • Satheesh Elangovan, BDS, DSc, D Med Sc  Bio
  • Georgia K. Johnson, DDS, MS   Bio
  • Theo Katsaros, DDS, DMD   Bio
  • Paula L. Weistroffer, DDS, MS   Bio

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Patient Information
     
Referring Dentist Contact Information
     
Comprehensive periodontal exam and treatment
     
Requested periodontal treatment:
     
Instructions displayed after submitting this form.
     
Preferred on compact disc or other electronic medium.
     
To transfer patient records and radiographs electronically, please use our HIPAA compliant and secure website. Call Central Records at 319-335-7429 for instructions. Include your office name/phone number, patient name/date of birth, and date radiographs made.
     
Please contact the Periodontics Clinic by telephone, Fax, or mail to set up an appointment with Dr.: