Please do not use this form to cancel an appointment under any circumstances. To change or cancel an appointment, kindly phone our dental office at 203-562-0234 to help avoid any cancellation fees.
Request Dental Appointment

You can also make a dental appointment by calling 203-562-0234 during normal business hours. You can speak directly with an associate that will best meet your oral health care needs. If you wish to complete this process online, you can do so by completing the simple form below.
Once we receive your request, one of our office associates will be in contact with you to confirm and complete the process!
Send An Appointment Request
This form not to be used to cancel an appointment.