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Last Name: Periamesa

First Name: Jim Karlo

Middle Name: Agpaoa

Birthdate: December 30, 1988

Age: 29

Street: Malugay

Barangay: SMDP

City: Parañaque

Country: Philippines

Zip Code

Contact number: 9258552756

Email: jkperiamesa@gmail.com

Procedure: 01-05-2018 > ADJ. SHARK > COIL 41-31 > CHAIN = 22,000 > CLASS II ELASTIC > OP 01/10/23- 31,32 Direct Veneers/LC 4Teeth/op/polishing/ozone

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Retain Record: Yes