Appointment Request

Welcome to our Appointment Request  at

CURRENT PATIENTS : HAS YOUR INSURANCE CHANGED : We will not be able to see your child if you come in for an appointment and tell us the same day that your insurance has changed .Call us and speak to someone at least ONE WEEK BEFORE your next appointment so we can give your directions on how to submit your new insurance information. We need to verify and check your benefits  before your next dental appointment . Please review the insurances our office does accept below .

NEW PATIENTS :  Please contact our office via telephone  and we will  provide you with paperwork which will need to be completed before we schedule your child's appointment.

Insurances Our office accepts United Healthcare PPO  , Aetna PPO, Cigna PPO, Delta Dental PPO, Metlife PPO


*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.):

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.