Requested times might not be available. We will contact you to confirm or offer like launch times. If you prefer to leave out sensitive information prior to submission of request, we can contact you to complete your enlistment over the phone.
First and Last Name:
Preferred Appointment Date:
Choose a Time:
Reason for Appointment:
Exam, Cleaning and X-Ray
Toothache or Other Emergency
Children in pre-school and elementary grades are usually seen in the morning. Late afternoon appointments are reserved for middle and high school age patients.
Please type "123" in the box below to complete submission: