STATEMENT OF ACCOUNT Thomas J. Magnani, D.D.S. 7W51 DENTAL GROUP 7 W 51st Street, Floor 7 New York, NY 10019 a CREDIT CARD # a NAME. GUARANTOR NAME AND MAILING ADDRESS Mr Jeff Epstein 9 East 71st Street SIGNATURE New York, NY 10021 ene SECURITY CODE 09/15/2017 Balance Forward 09/19/2017 Prophylaxis-adult 09/19/2017 Periodic oral evaluation 09/26/2017 Office Visit 09/28/2017 Crown-porcelain/ceramic substr 09/28/2017 Permanent Cement 09/28/2017 Office Visit 10/03/2017 AMEX Payment - Thank You 2400.00 Make checks payable to: Thomas J. Magnani, DDS. To pay by Credit Card, please call our office FS ©1987-2012 Henry Schein, Inc. ThomadF"Kijgnani, 0.0.5. - 7W51 DENTAL GROUP 7 W Sitst Street. Floor 7 New York, NY 0 EFTA00292242

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From: Lesley Groff ‘cstey j< all. CORT Subject: Jetfrey has been to Or. Magnani Sept. 27 & 28 Date: September 28, 2017 at 9:19 AM To: Bella Kleii Jeffrey has been to Dr. Magnani yesterday and today for some work..not sure what the work is...but be aware you will see charges for him Sept. 27th and 28th... EFTA00292243