Patient Registration

~ ~IMPORTANT~ ~

INSURANCE

WE PARTICIPATE WITH UNITED CONCORDIA, (FEE FOR SERVICE onlyDELTA DENTAL PPO/ PREMIER

ALL OTHER INSURANCES ARE PAYMENT IN FULL UPFRONT 

ADDITIONALLY:

*There is a $75 charge for all late cancels/ missed appointments.

*Completed forms PRIOR to the scheduled appointment are required to keep the appointment. There may be a $35 charge to complete forms in the office, at the time of the appointment.  

*We can mail paperwork to you if you prefer or we offer paper copies located in the foyer of the building. There is a drop box as well for paperwork, referral slip & x-rays.

*Please have your referral slip and x-rays emailed to us by your general dentist prior to your appointment.

If you have questions concerning the information for patient registration, please contact us. Our staff will be happy to answer any questions you may have. 

 The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.