CROWNS - SINGLE RESTORATIONS ONLY | January 1, 2025 INTERIM CROWN – FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS NECESSARY PRIOR TO FINAL IMPRESSION
OTHER RESTORATIVE SERVICES | January 1, 2025 RE-CEMENT OR RE-BOND INLAY, ONLAY, VENEER OR PARTIAL COVERAGE RESTORATION
OTHER RESTORATIVE SERVICES | January 1, 2025 RE-CEMENT OR RE-BOND INDIRECTLY FABRICATED OR PREFABRICATED POST AND CORE
