San Mateo County Dental Society | Every Member. Every Day. Summer 2020
In This Issue:
▪ Message From Our President
▪ Arthralgia: Demystifying Pain to find a Definitive Diagnosis
▪ And much more.....
2020 Member Events Calendar
See upcoming events art
New / revised course info highlighted in bold text
for details and registration.
2 | San Mateo County Dental Society | smcds.com
2020 Executive Board
President: Benjamin A. Yount, DDS
President Elect: Brad Hart, DDS
Treasurer, Secretary: Purvi K. Zavery, DDS, MS
Immediate Past President: Sara A. Andrews, DDS, MS
2017 Past President: Benson Wong, DDS
CDA Trustee: Carliza A. Marcos, DDS
Executive Director & Editor: Nakia Brandt
San Mateo County Dental Society
525 Veterans Blvd, Suite 102
Redwood City, CA 94063
twi er.com/ SMDentalSociety
James V. Aicardi
Printer / Designer
Press Print, Inc.
2 Event Calendar
7 New Members
8 Milestones / In Memorium
9 Business Members Wall of Fame
10 Orofacial Myofunconal Therapy
Arthralgia: Demysfying Pain to
Find a Definive Diagnosis
Combang Stress with Mindfulness
All expressions of opinions and statements
of facts contained herein are published on
the authority of the writers and or editors
and are not to be construed as the official
views of the San Mateo County Dental
All editorial contributions are subject to
space and/or content editing at the
Mouthpiece | Summer 2020 | 3
Ben Yount, DDS
The SMCDS staff and the board have been tirelessly (and
joyfully) working to provide you with the latest information
pertaining to our profession. COVID-19 created a time of
crisis in our industry and the need for immediate
information regarding employment law, HR concerns,
PPP/EIDL loans, PPE changes, new requirements, and backto-work
strategies was a hurdle. The COVID-19 pandemic is
a moment in our history that could not have been predicted
and during our shutdown for nearly 3 months organized
dentistry on the local, state, and national level came
together. We took that time to assess the situation, to
financially prepare our dentists, and to prepare the dental
teams to go back and work in an environment that was safe
for all. COVID-19 is still here and it's still a threat, but I want
to take this moment to give you an update and discuss our
successes as well as go over the plans for the future.
Each week our executive director, Nakia Brandt meets via
Zoom with leaders from ADA and CDA. They discuss
changes, the needs of dentists whether it be through
government grants and loans, unemployment, the need for
PPE, etc. Our staff consisting of Nakia, Mike, and Jim have
been advocating for us during this time and providing the
most up to date information. We've had 3 member
webinars in which 523 people have attended. In terms of
COVID-19 broadcast emails, there were 89 sent out from
March 3, to July 13, and there were 33,536 opens and
10,697 links clicked! Those numbers are staggering.
Currently we have 678 members which is up from this time
last year and SMCDS dentist members' account for over
78% of the dentists in San Mateo County.
The SMCDS board has met regularly and it has been our
mission to help our members prepare for a secure future
along with ensuring the long-term stability of the society
itself. We keep up to date on the financials and make
decisions for the greater good of the society which in turn
will benefit the dental community and the communities we
serve for years to come. I have truly witnessed the magic of
what being a part of organized dentistry is and we are
Sadly, we are still mourning the loss of our beloved staff
member Shirley Powell. She was a tender soul and
someone whose words of genuine encouragement did
exactly what she intended. She lifted our spirits and as your
president she coached me before and after various
membership meetings and always made me feel great.
Mike, Jim, and Nakia worked closely with her and miss her
very much. Please keep them in mind.
These are tumultuous times for everyone and to varying
degrees. Be kind to one another and recognize that life is a
delicate balance and it's fragile. It is my honor to be your
president and please contact the dental society if you have
any concerns or if there is something we can help you with.
Ben Yount DDS
4 | San Mateo County Dental Society | smcds.com
Carliza A. Marcos , DDS
Well…it seems like forever since my last update. I hope this
finds you well and safe.
Like many of you, the events of the recent months have
brought fears, tears, and countless sleepless nights thinking
about the solvency of our businesses and the state of our
world. We are living through this extraordinary time that has
forever changed our organization, our practices, and our
Through our 10 weeks of mandated shelter in place (SIP) and
the recommended “emergency care only”, CDA has
continued to protect our profession and patients. SMCDS is
very fortunate to have a wonderful executive director who
has kept our members up to date with frequent email
updates on the latest CDA and CDC news. I encourage you all
to read Nakia's updates as they keep you in the loop with
this constantly changing landscape. The CDA website
www.cda.org is also an incredible resource for questions
about patient care, HR inquiries, provider relief funds, SBA
loans, licensure, and CE requirements etc.
The Board of Trustees (BOT) “met” weekly via zoom for
informal updates during the months of SIP. For me, it was a
great source of support during the chaos and uncertainty of
the first few weeks of our shutdown. We were given regular
reports on the progress of conversations with the
governor's office, CDC, and local county health
departments. Since most of California's dental offices have
re-opened, our BOT informal calls have shifted to twice a
month. That's a good sign as latest reports indicate that
many dentists and leaders are just making up the backlog of
patient treatments. It is estimated that most dentists are on
average 60-70% of their pre-COVID-19 production.
Some other relevant information:
The remaining of the year's meetings, including the
ADA and CDA House of Delegates will be held
CDA Presents in Anaheim and San Francisco were
canceled this year; however, the CDA Board of
Managers provided virtual CE courses and plan to
do the same for the Fall meeting. They are looking
ahead to 2021 and looking at a hybrid model (part
virtual and part in person) for scientific sessions
CDA President Dr. Rick Nagy convened two
workgroups during SIP : the clinical workgroup and
economic relief workgroup. There is also an office
staffing workgroup that has just been created.
The CDA Finance Committee and BOT have been
stress testing best and worst case scenarios to
manage the sustainability and financial health of
CDA during this crisis. Rest assured that CDA is
being proactive to keep our organization fiscally
responsible and strong through the challenges that
COVID-19 has presented us
A ballot initiative was filed to raise the cap on
MICRA (Medical Injury Compensation Reform Act).
The CDA has joined an opposition coalition made
up of heath care providers, hospitals, and
insurance companies. We expect this issue to be on
the 2022 ballot
Finally, I ask you all to continue to support organized
dentistry. Now-more than ever- we see the value in a
united front to help get our members and patients get
through these un-precedented times.
As always, if you have questions, concerns, and/or
suggestions - please feel free to reach out to me by phone
(415)309-7693 or email email@example.com
Carliza A. Marcos, DDS
Mouthpiece | Summer 2020 | 5
Advertisers Business Members Exhibitors Sponsors Study Clubs
who have generously supported our continuing education, professional success,
practice management, workshop/clinical programs this past quarter.
6 | San Mateo County Dental Society | smcds.com
Join us in celebrating 26 new members
contributing over the course of the first half
of 2020 to the voice that is SMCDS - 658
Mouthpiece | Summer 2020 | 7
We are saddened by the loss of …
Martin E. Frankel, DMD, MDS – Marty was one of the founding fathers in the field of TMD and
Orofacial Pain. He attended Tufts College, Tufts Dental School, Tufts Orthodontic Program and
simultaneously completed his masters in Dental Science. He opened a private Orthodontic
practice in Hempstead, N.Y. and became Chief of the TMJ Clinic at both N.Y. Eye and Ear and North
Shore Medical Center. He relocated to California where he completed a Prosthodontic residency
at UCSF Medical Center. He opened a private practice in San Francisco and Palo Alto limiting his
practice to TMD and Orofacial Pain. He became an adjunct clinical professor at Stanford University
Medical Center. He was a member of numerous societies including F.A.C.D., F.I.C.D., ABOP, AAOP,
AAO, and published numerous articles and enjoyed lecturing nationally and internationally.
His friends and family knew if something had to get accomplished “Just Ask Marty”
He will surely be missed by his family, friends, colleagues and all the people he helped throughout
He is survived by his wife Cheryl, sons Jonathan (fiance' Jasmine), Matthew (dautghter-in-law
Allie) and grandchildren Zoey and Noah.
James Miller “Jim” Holmes,
DMD – Redwood City General
Dentist and SMCDS member of
48 years - passed away April 14.
Jim graduated Oregon Health
Science University in 1971 and
practiced his entire career in
Redwood City before retiring in
Edward M. O'Reilly, DDS –
South San Francisco General
Dentist and SMCDS member of
17 years - passed away January
11. Ed graduated Creighton
University Boyne School of
Dentistry 1963 and practiced his
entire career in South San
Francisco before retiring in
James S. Kim, DMD – Millbrae
General Dentist and SMCDS
member of 33 years has
retired and sold his practice to
8 | San Mateo County Dental Society | smcds.com
SMCDS Business Member
Premier 2020 - 2015
Vantage Wealth Management
® ® ®
Tom O’Brien,CFP , CLU , CHFC
Living Benefits Geek
Platinum 2020 - 2015 | Silver 2014
Platinum 2020 - 2015 | Silver 2015
Endorsed 2020 - 2010
Yaeger Dental Supply
Tim Yaeger, Jr.
TDIC Insurance Solutions
Vice President Healthcare Financing
Platinum 20 20
Vice President Dental Financing
Broker, Northern California
Dental & Medical Counsel, PC
Ali Oromchian, Esq.
firstname.lastname@example.org Platinum 2020
SMCDS Business Members acknowledged on this
contribute in meaningful ways* throughout
each year of their membership to our society’s fiscal health, industry intelligence, and community presence. *Event sponsorships,
educational seminars / workshops, table clinics with timely dental industry / small business information, special product offers /
pricing discounts, products and services relevant to your professional success and the oral health of our community. Business
Memberships are an important source of non-dues revenue that has helped SMCDS to increase and improve
member programs without raising SMCDS dues for more than a decade. We count on Business Members to engage professionally
with members - as consultants focused on identifying and fulfilling your needs. In exchange, we encourage you to consider
SMCDS Business Members as preferred providers when in the market for products and services.
Membership Levels: Premier $5,500 Platinum $4,000 Gold $2,900 Silver $2,100
Mouthpiece | Summer 2020 | 9
Orofacial Myofunctional Therapy:
The Key to Successful OMD Treatment
Lauren Ibarra, RDH
Orofacial Myofunctional Therapy (OMT) is a field that has
been around for a while, that many of you may not have
heard of. OMT is a growing field that is becoming more
integrative and collaborative with dentistry. OMT is the
retraining of the muscles of the face and mouth to eliminate
behaviors and habits that are causing structural and
functional issues. These behaviors and habits are generally
referred to as orofacial myofunctional disorders or OMD's.
OMD's may affect airway function, sleep quality,
breastfeeding, facial skeletal growth, swallowing, speech,
occlusion, TMD, oral hygiene, orthodontic treatment and
As a hygienist with a background in OMT, I see the
connection on a daily basis. Some examples of OMD's we all
see in our patients include: mouth breathing/open mouth
posture, tongue thrust, thumb or digit sucking, nail biting
and tongue tie. Orofacial Myofunctional Therapists (OMT's)
work collaboratively with other specialists such as Dentists,
Orthodontists, Oral Surgeons, Pediatricians, ENT's, Physical
Therapists, Speech Language Pathologists and others.
An example of an OMD I see regularly is oral versus nasal
breathing. The tongue resting on the roof of the mouth is
key to shaping the Maxilla. In a mouth breathing scenario,
the opposite occurs as the tongue rests low in the mouth.
This leads to the formation of structural changes of the
bone and occlusion. The maxilla eventually develops a
narrow high arch, the teeth become more crowded
resulting in less room for proper tongue rest posture. As we
know, the roof of the mouth is the floor of the nose,
therefore deviation of the nasal septum may also occur as
the maxilla narrows, which makes nasal breathing more
challenging and exacerbates the compensation to mouth
breathe even more.
Another example of an OMD affecting dentistry would be a
tongue thrust swallow pattern. This can be a nightmare for
orthodontic relapse and prolonged treatment, if not
addressed. Tongue tie is another OMD that can cause the
inability of the tongue to properly clean the teeth and oral
cavity of food debris, which can increase caries rate. Other
issues associated with tongue tie can be: reflux, sleep
breathing disorders such as snoring, apnea, hypopnea,
speech issues, tongue thrust and crowded dentition. These
are just some examples of how an OMD contributes to the
form following the function.
So how do I explain to my patients what myofunctional
therapy is and its importance? I like to use the example of
poor posture. Sometimes poor posture is caused by
improper or lack of use of our musculature, whether it be
during use, or at rest. Over time, due to lack of use, the
musculature may become flaccid. The muscles that are
dominantly engaged will start to overcompensate for the
weaker ones. Eventually this can result in physical changes
(slouched appearance), pain in joints (hips or knees), or
pain in the overworked muscles (muscle spasms). A similar
scenario can occur in the muscles of the face and mouth, as
well. Myofunctional therapy is like detective work.
Determining the underlying cause(s) or “the why” of a
muscular compensation(s) is key to successful treatment of
the OMD's. Once this is achieved, creating new
neuromuscular patterns to replace existing compensations
will be the end goal of therapy. Therapy can last up to a year
depending on the degree and number of the OMD's not to
mention the intensity, duration and frequency the patient
puts into doing the therapy at home. The end results of
better breathing, sleep quality and overall health are
10 | San Mateo County Dental Society | smcds.com
Arthralgia: Demystifying Pain to
find a Definitive Diagnosis
Andrew Young, DDS, MSD
A 71 year-old Caucasian male presented with the chief
complaint of pain in his lower right quadrant, involving the
posterior teeth and the angle of the mandible.
His pain had been present for the past 9 years. His dentist
suspected #31, so RCT was performed. Pain resolved for a
couple weeks, but returned. It was then extracted, with the
same short-lived relief.
The constant ache had an intensity of 2-6 out of 10. Advil
400 mg would eliminate it for a day. 5-20 minutes after
brushing or chewing, it would worsen.
TMJ palpation caused mild pain in the right TMJ. Opening
was a painless 42 mm. Laterotrusions were each 13 mm.
Left laterotrusion and protrusion caused a mild “sensation”
from the angle of the ramus to the TMJ, reproducing the
Palpation of the right superficial masseter caused moderate
pain, the left felt mild pain, and the right deep masseter felt
mild-moderate pain. All three reproduced the chief
The lower right quadrant was tested. The following
reproduced the chief complaint: vertical percussion of #30
and 32, and horizontal percussion of #32, biting on #31, and
periodontal probing of the buccal surface of #31. The
following were painless: apical palpation, an explorer
scraped along the cervical portions, and cold-testing.
Prior to the exam, his pain intensity was 2. Following the
muscle palpation and dental exam, his pain reached 6.
Topical 20% benzocaine was then applied to the gingiva in
site #31, as well as the buccal gingiva of #30 and 32. Ten
minutes later, the pain decreased to 1-2. 45 minutes later, it
He was diagnosed with arthralgia of the right TMJ and
myofascial pain of the masseter muscles with referral to his
lower right quadrant.
He was instructed to take ibuprofen 400 mg, QID for 1
month for his TMJ arthralgia. He was taught to self-massage
his masseter muscles for one minute every hour and to do
warm and compresses daily for 10-20 minutes each; all were
done with stretching. Massages and compresses help clear
muscles of algesic agents, and stretches do the same for
muscles and joints.
After one month, he had no more pain.
Some findings warrant discussion. Why did the pain
disappear with topical anesthetic? Before the exam, his
pain level was 2. The subsequent muscle palpation, range of
motion tests, and staying open for the quadrant testing,
irritated his muscles. Then topical anesthetic was applied,
followed by waiting for it to take effect, which allowed his
muscles to recover.
Why had the previous root canals and extractions made his
pain disappear momentarily? For some time following
those treatments, he took analgesics and ate soft foods.
Why had the percussion tests reproduced the chief
complaint? The sore muscles hypersensitized the entire
region. The biting test for #31 hurt because biting requires
contracture of the sore masticatory muscles.
This case demonstrates the occasionally confusing nature of
pain, and how a complete history, description, and physical
examination can lead to diagnoses and resolution.
Note: Dr Young currently treats patients at UOP and Arthur
A. Dugoni School of Dentistry in San Francisco.
Mouthpiece | Summer 2020 | 11
Combating Stress with
Mark Abramson, DDS
Burnout is a long-term stress reaction characterized by a
state of emotional, mental and physical exhaustion and a
lack of a sense of personal fulfillment and accomplishment,
however, there is a solution: Mindfulness practices not
only reduce stress, but actually lead to physical changes in
the brain that can alter mood and quality of life.
Stress and anxiety are daily facts of life for many people and
running or working in a dental practice can be particularly
stressful. The ADA Center for professional Success notes:
Stress can occur in various ways throughout your normal
workday: Handling an anxious patient, performing a not-sofamiliar
procedure, or managing the intricacies of health
insurance plans are all cumulative stressors that make an
impact by day's end.
The ADA discovered that of dentists:
• 79.4 percent feel low in energy
• 55.8 percent blame themselves for things gone wrong
• 34.9 percent feel hopeless about the future
• 29.1 percent have no interest in things
• 23.5 percent have feelings of worthlessness
• 41.9 percent have difficulty concentrating and making
Of these respondents, 22.6 percent indicated moderate to
severe depression. Other studies found similar responses:
34 percent frequently or always felt physically or
emotionally exhausted and 47 percent were somewhat
happy to unhappy with little interest in life.
What is Mindfulness?
Mindfulness, defined as non-judgmental, moment to
moment awareness, has been shown to be an effective
stress reduction practice. A 2011 study published in Clinical
Psychology Review concluded that the practice of
mindfulness “brings about various positive psychological
effects, including increased subjective well-being, reduced
psychological symptoms and emotional reactivity, and
improved behavioral regulation.” To assist dental
professionals, Dr. Mark Abramson worked with the ADA
Center for Professional Success to develop a series of
videos on mindfulness. These videos aim to help dental
professionals, staff and patients create a more healthy and
happy work environment. Stanford medical center has also
formed a committee to address stress in amongst clinicians
and has recommended classes in mindfulness and
compassion training, in which Dr. Abramson took part in
teaching. Educational videos were also created designed to
develop greater mindfulness in the routine activities of
How does one practice mindfulness?
Finding techniques to refocus the mind on the present
moment and quieting the mind from all the “noise and
chatter” of daily life.
Mindfulness can be performed daily during our clinical
work routines: one of the practices is to make a meditation
of washing one's hands or scrubbing up for a procedure.
Simply focusing on the sensation of the soap, water and
feeling of touch acts to center and relax the mind and body
that support better performance and it does not require
any additional time to do.
Is there Science To Prove Mindfulness Works?
Neuroscientist Sara Lazar found that people who practiced
meditation had more gray matter in the part of the brain
linked to decision-making and working memory: the frontal
cortex. She noted during an interview with the Washington
Post (Schulte 2015,) “meditation had been associated with
decreased stress, decreased depression, anxiety, pain and
insomnia, and an increased quality of life.” In her research
paper, Lazar et. Al, (2005) Meditation experience is
associated with increased cortical thickness Neuroreport.
2005 Nov 28; 16(17): 1893–1897, the authors looked at
long term meditators vs a control group.
“We found long-term meditators have an increased
amount of gray matter in the insula and sensory regions,
the auditory and sensory cortex. Which makes sense.
When you're mindful, you're paying attention to your
breathing, to sounds, to the present moment experience,
12 | San Mateo County Dental Society | smcds.com
and shutting cognition down. It stands to reason your senses
would be enhanced.” She explained.
“We also found they had more gray matter in the frontal
cortex, which is associated with working memory and
executive decision making. It's well-documented that our
cortex shrinks as we get older – it's harder to figure things
out and remember things. But in this one region of the
prefrontal cortex, 50-year-old meditators had the same
amount of gray matter as 25-year-olds. So the first question
was, well, maybe the people with more gray matter in the
study had more gray matter before they started meditating.
So we did a second study.
We took people who'd never meditated before, and put one
group through an eight-week mindfulness- based stress
We found differences in brain volume after eight weeks in
five different regions in the brains of the two groups. In the
group that learned meditation, we found thickening in four
how I should feel all the time!” But you can't get more than 3
good night's sleep per year because of the circumstances of
your life. Well, with TM (meditation) you can have that every
Oprah Winfrey: “That way of being 'still' with ourselves –
coming back to the center and recognizing that something is
more important than you – it's more important than the
work you are doing, brings a kind of energy, an intention that
we have never had before.”
Bringing mindfulness to yourself, your patients, and your
team. Teach your patients about proper breathing and
encourage them to hold some awareness of their
breathing…be a value added practice. This can help the
fearful and anxious patient immensely. By being the natural
centering effect that mindful presence brings you will be a
calming presence and guide for your patients.
1. The primary difference, we found in the posterior
cingulate, which is involved in mind wandering,
and self relevance.
2. The left hippocampus, which assists in learning,
cognition, memory and emotional regulation.
3. The temporo parietal junction, or TPJ, which is
associated with perspective taking, empathy and
4. An area of the brain stem called the Pons, where a
lot of regulatory neurotransmitters are produced.
The amygdala, the fight or flight part of the brain which is
important for anxiety, fear and stress in general. That area
got smaller in the group that went through the mindfulnessbased
stress reduction program. The change in the
amygdala was also correlated to a reduction in stress levels.”
Who Else Practices Meditation?
Steve Jobs: "If you just sit and observe, you will see how
restless your mind is. If you try to calm it, it only makes it
worse, but over time it does calm, and when it does, there's
room to hear more subtle things - that's when your intuition
starts to blossom and you start to see things more clearly
and be in the present more. Your mind just slows down, and
you see a tremendous expanse in the moment. You see so
much more than you could see before. It's a discipline; you
have to practice it.”
Jerry Seinfeld: “Do you know how three days a year you get a
good night's sleep? And you wake up and feel like “Oh, this is
Resources developed by at Stanford University regarding
mindfulness can be found here:
The ADA Center for Professional Success has developed
resources regarding stress management as a member
Mouthpiece | Summer 2020 | 13
www.rectanglehealth.com | email@example.com
How to Restore Dental Operations Safel and Effectively:
Sedation and Anesthesia for the Dental Office
MICHAEL LAM, M.D.
Board Certied Physician Anesthesiologist
MAXIMIZE SAFETY FOR YOUR PATIENTS.
INCREASE PATIENT COMFORT AND CONVENIENCE
OPTIMIZE OPERATING CONDITIONS.
16 | San Mateo County Dental Society | smcds.com
(650) 743-3349 | firstname.lastname@example.org
Mouthpiece | Summer 2020 | 17
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18 | San Mateo County Dental Society | smcds.com
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517 Marine View, Suite J • Belmont, CA 94002
Tel: 650.593.5100 • Fax: 650.593.1331
email@example.com • www.yaegerdental.com
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Mouthpiece | Summer 2020 | 19
Seeking Associate to buy in State of
the Art San Bruno Facility in a major
thoroughfare with Youtube, Tanforan
mall, Bart Station, Caltrain in our
backyard. Especially new apartment
retail complex being built across the
street. 2,121 Sq Ft, 4 Treatment Fully
Equipped Rooms with A-DEC Chairs
& Units, Large Reception Area &
Large Front Desk Area, 1 Billing
Nook, Pano, 1 Sterilization Room,
Lab Room, Treatment Consultation
Room, Storage Room, Lunch room, 2
Restrooms, 2 Additional Treatment
rooms fully plumbed with cabinetry.
Contact 650.228.6880 or
Thinking of retiring or slowing
down? Want to practice but not
manage? Local dentist seeking a
practice to buy in San Mateo, 2 mile
radius from downtown. Not corp
dentistry. Please call 415.269.6254
Would you like to reduce your rent
by 50%? General Dentist of 20 years
seeking an opportunity to sublease
in a practice in Foster City, San
Mateo or Burlingame. Contact Dr.
Victor Sobrepena 650.619.6250 or
2 Chayes Virgina Dental Chairs
La Siesta Model gray color work well,
upholstery fair. I was given 2 new ones
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Email: firstname.lastname@example.org for photos
Seeking a Retiring Dentist Practice
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radius from Whipple and El
Camino. If you are thinking of
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Full time general dentist, hygienist
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days a week, Monday, Friday &
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Please respond with a detail resume
including all previous employment
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Email address: Bellerk@yahoo.com
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20 | San Mateo County Dental Society | smcds.com