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Get Pdf Msa 1680b

Michigan.gov/mdch click on Providers Information for Medicaid Providers Medicaid Provider Forms and Other Resources scroll down to find the form number MSA-1680-B. Bulletin Michigan Department of Community Health Bulletin Number Distribution Issued Subject MSA 07-57 Dentists and Dental Clinics October 1 2007 Revised Dental Prior Authorization Form MSA-1680-B Effective November 1 2007 Programs Affected Medicaid CSHCS Effective for dates of service.

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