Appointment Request

Offer for first time patients 

First time visit for the low risk cost of $121.00!

This appointment will include:

A Comprehensive Exam, Oral Cancer Screening, X-Rays, CT Scan, Clinical Photos, Treatment Consultation, and Have all of your questions answered

Usual Value of $511.00

We want to help you achieve your goals!

The first step towards a natural, healthy, functioning 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.

*Items in bold are required.
Are you a current patient?

Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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