5952 Royal Lane, Suite 258
Dallas, Texas 75230

214.691.5651

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Emergencies Welcome

& Seen Same Day!
 

Friendly Staff

(Each Has A Gentle Touch)

 

Teeth Whitening

 

Digital X-rays

(Up to 90% less radiation)

 

Headache Prevention

 

Flexible Payment Options

 

Patient Information

 

 

Save Time In Our Office

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

 

Click on the forms to begin download process. When prompted, select 'Open' or 'Run' and then select the option to print. Viewing forms requires Adobe Reader.

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  Patient Registration Form

  Medical History Form

  HIPAA Forms (Health Insurance Portability and Accountability Act)

 

Please do not mail the completed forms to the office. Please bring them with you at the time of your scheduled visit.

 

 

 

Payment Options

We accept all major credit cards.

 

Financing

The office also accepts the option of payment through Care Credit -- a financing program for elective medical procedures.  Patients may be pre-approved for Dental Fee Plan Financing with a low-interest monthly payment plan. Please contact our office for more information on financing options.  Learn More

 

 

 

 

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