Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before?: *

Yes No  

What is the reason for the appointment?: *

  Regular Exam / Cleaning
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:

 

Confirmation

How do you prefer to be contacted?: *

  Email   Phone  

 
 

It may take a moment to submit your information. Please wait for a confirmation message.

 
Check Out Great Grins for KIDS!

•  Specialized in Dentistry for Infants,
Children, Adolescents and Special Needs Patients
•  Affordable-Payment Plans available
•  Accepting New Patients
•  Quality Care
•  Experienced Staff
•  Fun Atmosphere
•  Cavity Free Club
•  Accepts Most Insurances


971-470-0045
911 Main Street
Suite 140
Oregon City, OR 97045
Click to Expand Map and Get Directions
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