If you have an emergency, DO NOT complete this form. Call our office at (937) 335-7754 so that we can schedule you as soon as possible.
After we receive the Appointment Request, we will contact you via email or phone to confirm the time and date of your appointment. Please allow two business days for us to schedule your appointment. If you wish to visit the dentist office sooner, please call 335-7754 so that we can accommodate you at the earliest time possible. We look forward to providing you with the best service possible.