15104 Space Maintainer, Band Type, Fixed, Bilateral (soldered lingual arch), with Teeth Attached
| 10000 | PREVENTION |
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| 15000 | SPACE MAINTAINERS |
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| 15100 | SPACE MAINTAINERS, BAND TYPE |
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| 15104 | Space Maintainer, Band Type, Fixed, Bilateral (soldered lingual arch), with Teeth Attached |
$342.71
+Lab Costs |
$342.71
+Lab Costs |