https://enterpriseforms.revenuewell.com/patients/register/7a03dec1-f40c-4182-8831-f2c9aa9b1a10/packet/8146

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https://bit.ly/ALDphxformRedirected
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JavaScript Variables · 20 found

Global JavaScript variables loaded on the window object of a page, are variables declared outside of functions and accessible from anywhere in the code within the current scope

NameType
onbeforetoggleobject
documentPictureInPictureobject
onscrollendobject
dataLayerobject
google_tag_managerobject
google_tag_dataobject
_fs_hoststring
_fs_scriptstring
_fs_orgstring
_fs_namespacestring

Console log messages · 0 found

Messages logged to the web console

HTML

The raw HTML body of the page

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css-14ybvol"><h6 class="MuiTypography-root MuiTypography-subtitle1 css-lnglo7"> Advanced Laser Dentistry - Phoenix </h6><h6 class="MuiTypography-root MuiTypography-subtitle2 css-nsbuu6">6819 N. 16th St Suite 4  <br>Phoenix, AZ 85016<br>602-840-5100</h6></div><div class="MuiGrid-root MuiGrid-item MuiGrid-grid-xs-2 css-o0rlmm"></div></div></div></div></div><script>window._fs_host="fullstory.com",window._fs_script="edge.fullstory.com/s/fs.js",window._fs_org="175CP5",window._fs_namespace="FS",function(n,e,t,o,s,c,i,f){t in n?n.console&&n.console.log&&n.console.log('FullStory namespace conflict. 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