Contact Us

Do you have a question or would you like an appointment?
- Ask a Question
- Request an appointment
Your Name*
First Last
Email*
Phone
Message
We work hard to accommodate our patients' appointment needs, however, we may not be able accept all requests. If you need to see the dentist within the next few days, please call us directly at 615-713-1993 to speak to our patient care coordinator.
Patient's Name
Patient's Date of Birth*
Month
Day
Year
Appointment Type*
- Pediatric Dentistry
- Orthodontics
Date
1st Choice 2nd Choice 3rd Choice
Preferred Time

: Hours

Minutes

AM/PM
Preferred Time

: Hours

Minutes

AM/PM
Preferred Time

: Hours

Minutes

AM/PM
Notes
*If you're booking for multiple patients, please provide additional information here, including their date of birth and name.
*To help expedite the process, you may also provide your dental insurance information.
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