New Patient Offer

50% Off Teeth Whitening
for
New Patients

This is a non transferable one time offer for new patients.
Offer expires 1 year after initial exam.
After initial exam patient must be found to be eligible for bleaching (teeth whitening).

Complete the form below to take advantage of this offer!


Appointment Request

If you would like to request an appointment, simply complete the form below and we will be in touch with you soon.

Note: We do not accept CONFIRMATIONS or CANCELLATIONS via this form. If you need to confirm or reschedule your appointment, please call our office.


Your Name:

Street Address:

City, State Zip Code:
,

Preferred Phone:

Email Address:

Day Preference:

Time Preference:

Add your comments below:


Please enter code above in the field below.