Appointment Request

We want to be your family's home for quality dental care!

 

Our friendly and professional team is eager to serve you. We offer convenient scheduling to cater to busy families like yours. Fill out this form to request an appointment online or call (734) 971-2200. One of our team members will happily help you schedule a convenient appointment time.


Please do not use this form to cancel or change an existing appointment.


Office Hours:

Tues: 8:00am - 5:00pm
Wed: 8:00am - 7:00pm
Thurs: 8:00am - 2:00pm
Fri: 8:00am - 2:00pm
*Items in bold are required.
Are you a current patient?


Which office location(s) would you prefer for your appointment?


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.