INFORMACIÓN DEL PATIENT
SEGURO DENTAL
NÚMEROS DE TELÉFONO
HISTORIA DENTAL
HISTORIA DE SALUD
ACTUALIZACIONES (Para completar en futuras citas)

Todos los beneficios del seguro, cualquiera que sea, pagaderos a mí por los servicios prestados. Entiendo que soy financieramente responsable de todos los cargos, ya sea que los pague o no el seguro. Autorizo el uso de mi firma en todas las presentaciones del seguro.

El dentista mencionado anteriormente puede usar mi información de atención médica y puede divulgar dicha información a la Compañía de seguros mencionada anteriormente y sus agentes con el fin de obtener el pago por los servicios y determinar los beneficios del seguro o los beneficios pagaderos por los servicios relacionados Este consentimiento terminará cuando se complete mi plan de tratamiento actual o un año desde la fecha firmada a continuación.

Dr. Lazaro Acosta

Dr. Acosta received his doctor in dental surgery degree from the University of Havana in 1990. He went on to specialize in Oral and Maxillofacial surgery in 1996, also at the University of Havana. In 2001, he moved to Chile with his family, where he received his Doctor of Dental Surgery degree from the University of Santiago. In his search for the American dream, he moved to the United States, and earned his Doctor of Dental Surgery degree from New York University in 2012. During his time at NYU, he was part of the Honors program in Oral Medicine. With a passion for continuing his education; he became an implant fellow at the University of Florida in 2014, attended a TMJ and Occlusion course with the Dawson Academy in 2016, and is in regular attendance at the Pykos Symposium, where he masters his skills in bone grafting and implants. Dr. Acosta is also honored to have been named Top Dentist of Naples consecutively since 2019, and to be selected as one of America’s Best Dentists by Marquis Who’s Who 2024. His accomplishments drive him to continue providing the best care to his patients, most of which have become like family throughout the years.