Patient Information
New Patient Form
**Please note that form may only be submitted using Internet Explorer.
Payment Types
Insurance, Personal Checks, All Major Credit Cards, Debit, Care Credit Financing Available
Patient Forms
A 10% courtesy is provided to patients paying in full by cash or check for procedures totaling $500 or more. Payment is due at the time of service. The full balance is due at time of service for minor procedures. For major procedures, 50% of balance is due the day the procedure is started and the remaining balance is due when he procedure is completed.
We will file your insurance each time you receive treatment in our office. If there is a co-payment for your treatment, it will be collected at your date of service.
Insurance
We accept all dental insurances, but we are in network with the following carriers:
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Delta Dental
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GEHA
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Metlife
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United Concordia
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Guardian
Care Credit is accepted at our office. For qualified applicants, they offer interest-free financing for 3 months - 18 months. Please contact our office, or visit www.carecredit.com for additional information.