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: 9:00am-2:00pm (Administration Hours)

Tuesday:  9:00am-2:00pm (Administration Hours)

Wednesday: 7:30am - 5:00pm

Thursday: 7:30am - 5:00pm 

Friday:  7:30am-5:00pm



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.