Medicare Waiver/Private Contract Sample Contracts

Charleston Oral and Maxillofacial Surgery Associates, LLC
Medicare Waiver/Private Contract • June 15th, 2021

This contract is entered into by and between Dr. Porter/Dr. Doles (hereafter called the “physician”), whose principal medical office is located at 2320 Cosgrove Ave Charleston, SC. 29405 and patient (hereafter called beneficiary), who resides at

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