OUR OFFICE IS LOCATED AT:

3037 East Commercial Blvd Ste A Fort Lauderdale, FL 33308.

PHONE/FAX:

+1 800 603 6035
+1 800 889 9898 fax

  • Appointment:

  • 3. Has a prophy been done at GP's office in the last 6 months?
  • 4. You used code D4341 or D4342 within the last two years?
  • Wisdom Teeth Evaluation:

  • A COMPLETE SERIES (Please check one):

  • ANTICIPATED TREATMENT PLAN: WHAT WOULD YOUR IDEAL ANTICIPATED TREATMENT PLAN BE?

  • 3. HAS A PROPHY BEEN DONE AT GP'S OFFICE IN THE LAST 6 MONTHS?
  • TO HELP US BETTER PREPARE:

  • 1. Is the patient physically handicapped?
  • Comments...
  • 2. Is premedication needed?
  • Comments...
  • 3. What is the patients apprehension level?
  • Comments...
  • PLEASE SEND ADDITIONAL:

Request an Appointment

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Office Hours

Monday: 8am-6pm
Tuesday: 7am-6pm
Wednesday: 7am-6pm
Thursday: 7am-6pm
Friday: 8:30am-5pm
Saturday: by appointment only
Sunday: by appointment only