25143 Three surfaces
| 20000 | RESTORATION |
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| 25000 | RESTORATIONS, INLAYS, ONLAYS, PINS AND POSTS |
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| 25100 | RESTORATIONS INLAYS |
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| 25140 | Inlays, Porcelain/Ceramic/Polymer Glass (Bonded) |
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| 25143 | Three surfaces |
$798.17
+Lab Costs |
$798.17
+Lab Costs |