Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

Office Hours:

Monday 11a -6p

Tuesday 10a – 6p

Wednesday 7a - 4p

Thursday 7a - 4p

Friday 7a – 1p 

Please information us of the type of dental insurance that you have in the additonal information box below.

Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.