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Directory Work Form
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Required: Historical Information
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Has the current practice ever changed address, phone number or name? If so, please list previous information.
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Have the current practitioners ever worked at a different place? If so, please list practitioner name, previous practices worked at and city, state worked in
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Have there been any other practitioners in the past that have worked at current location? If so, please list names
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Required: Practice Information / TNT to complete
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Practice Name
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Practice Phone *should be actual practice main line
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Full Address
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Office Hours
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Full Website URL (use the exact home page, ie https/www)
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Organic SEO payment plan - PER LOCATION - (397, 767, 1197)
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Primary Geo to target
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New Patient Map
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Brightlocal Pin
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Required: Descriptions and Photos
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750 character max Practice Description
*To be used on Google Business Profile, Facebook, Bing, Yelp Specialties section and yext. Note: You can enter the description or the T: Drive location
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Up to 1000 characters History of the Practice Description
*To be used on Yelp History section
*- Should be focused on practice history.
Note: You can enter the description or the T: Drive location
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Social Media and Custom Photos T drive location
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If Video team has created a 30 second profile video, add link to specific video file - ex: T drive path, shared dropbox link?
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Required Information: Primary Category. Mark X next to primary
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Dentist (Default)X
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Other Primary Dental Category Options (Choose 1, if not dentist)
Note: Only use if this is it what they mainly want to be found for
Non-Dental Related Category Research - https://pleper.com/index.php?do=tools&sdo=gmb_categories
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Orthodontist
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Cosmetic Dentist
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Pediatric Dentist
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Periodontist
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Dental Implants Provider
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Endodontist
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Dental Implants Periodontist
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Prosthodontist
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Oral and maxillofacial surgeon
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Oral Surgeon
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Sleep clinic
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Required: Logins and access verification
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Google My Business Owner Logins
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TNT account Google Business Profile shared to
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If no GBP logins, google logins to create/claim GBP under
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Facebook Page Owner Logins
*(Please note this is needed for SEO team to set up partner access and/or to change practice names on Facebook pages)
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TNT Facebook Partner Access
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Yelp Business owner Logins
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If no Yelp, email to claim Yelp under
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Healthgrades Pracitioner 1 Logins
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If no Healthgrades, email PER PRACTITIONER, to claim under
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Healthgrades Pracitioner 2 Logins
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If no Healthgrades, email PER PRACTITIONER, to claim under
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Optional Information for Practice. Strongly Recommended for SEO and Visibility
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E-mail to be used on directories *this is a public facing email that will be visible on some directories
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Practice Opening Month, Day and Year
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Accepts Insurance?
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List Insurance Companies Accepted
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Languages
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List any languages spoken
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Attributes and Amenities. Mark X next to applicable.
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Identifies as Asian-owned
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Identifies as Black-owned
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Identifies as Latino-owned
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Identifies as Indigenous-owned
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Identifies as Middle Eastern-owned
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Identifies as Pacific Islander-owned
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Identifies as Identifies as LGBTQ+ owned
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Identifies as veteran-owned
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Identifies as women-owned
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Identifies as Disabled-owned
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Has wheelchair accessible elevator
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Has wheelchair accessible restroom
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Has wheelchair accessible seating
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Has wheelchair accessible elevator
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Has wheelchair accessible restroom
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Has wheelchair accessible seating
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Has gender-neutral restroom
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LGBTQ+ friendly
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Transgender safespace
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Proof of vaccination required
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All staff fully vaccinated
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Masks required
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Staff wears masks
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Offers Telehealth
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Communicate via email
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Offers Military Discount
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Offers Same Day Appt
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Offers Next Day Appts
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Have free onsite parking
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Required: Pracitioner Information
*set of data per practitioner. 367 one main pracitioner, 697 up to two pracitioners
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Name
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Gender
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Degree (DDS, DMD?)
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State Medical License #
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Last 4 digits of DEA
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NPI #
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Optional Pracitioner Info. Strongly Recommended for SEO and Visibility
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Date of Birth*optional for HG - only used to calculate age shown
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Education – please list
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Undergraduate School and Year Completed
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Medical School and Year Completed
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Internships and Year Completed
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Residency and Year Completed
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Fellowship and Year Completed
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Credentials
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State(s) Licensed in