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Appointment Request

Welcome to our Appointment Request  at

The first step towards a beautiful, healthy smile for your child  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 provide a WORK and a DAYTIME CELL PHONE number so that we may reach you during our office hours 

Our office is currently accepting new patients age one  and older


*Items in bold are required.

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.):

Please visit our Welcome page at and learn more about our practice

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