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. Welcome!

PLEASE NOTE:

  • Standard Office Hours are:

Monday, Tuesday, Wednesday:  7:30am - 4:30pm   

          Lunch Hour: 1:00pm - 2:00pm

Thursday:  8.00:00am - 5:00pm 

          Lunch Hour: 1:00pm - 2:00pm

WE ARE CLOSED ON FRIDAYS

  • Please do not use this form to cancel or change an existing appointment. Please call our office at
  • (603) 610-8765 to reschedule.

If you cancel an appointment within 48 hours of a scheduled procedure or do not show for an appointment twice in a 12 month time period, you may be required to leave a desposit for your next visit.  To avoid this fee, 48 hour notice is required if you cannot make your set appointment.  A handling fee of $25 is charged for any returned checks.

 

 

 


*Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Email:
Phone:  
Are you a current patient?
Best time(s) to call?

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.):

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