Epstein Secrets

HISTORICAL STATEMENT 12/1/2014 to 3/3/2015 Thomas J. Magnanl D.D.S. Telephone: Alvin Grayson D.D.S. 7 West 51 at Street 7th Floor New York NY 10019 Mr. Jeff Epstein Date Accou 9 East 71st Street 1 3/3/201 New York NY 10021 ROM itta

nce 6/20/2014 Previous Balance 0.00 12/17/2014 Amalgam 2 Surface Perm. 350.00 350.00 12/17/2014 Recall Oral Exam 40.00 390.00 12/17/2014 Adult Scale & Prophy 180.00 570.00 12/17/2014 Bite Wings 4 Films 65.00 635.00 1/8/2015 Panoramic Film 0,00 635.00 1/8/2015 Ortho treatment adult 7,500.00 8,

Thomas J. Magnani D.D.S. Alvin Grayson D.D.S. 7 West 51st Street 7th Floor STATEMENT Telephone: N paying by veal can& entry Ho amour; you am OWN/ n aM lormitanca box and ■ ext Wow M

UR REMITTANCE TO INSURE CREDIT TO PROPER ACCOUNT Date Patient Description Charges Credits Balance 6/3/2015 Previous Balance 0.00 6/16/2015 Adult Scale & Prophy 180.00 180.00 6/16/2015 Recall Oral Exam 40.00 220.00 6/16/2015 Electric toothbrush 160.00 380.00 6/16/2015 Laser Bleaching 750.00 1,13

STATEMENT Thomas J. Magnani D.D.S. Alvin Grayson D.D.S. Mr. Jeff Epstein 301 East 66th Street Apt 1OF New York NY 10; rn kf Telephone: I paying by credit cant enter Me amount you are barna in

COLAIT Date Patient Description Charges Credits Balance Previous Balance 0.00 11/24/2010 Comprehensive Oral oval 50.00 50.00 11/24/2010 Adult Scale & Prophy 160.00 210.00 Account Total 210.00 We accept credit cards! You may complete and return the top part of this statement, or call the office at 21