Appointment Request

Welcome! The first step toward achieving a beautiful, healthy smile is to schedule an appointment. Please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

If you are interested in having your insurance benefits verified, please email us a copy of your insurance card at [email protected] or provide your insurance information in the form below. 

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly by phone at 919-570-0180 or by email at [email protected].

Contact Information:

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(919) 570-0180
Monday - Friday 6:45AM - 5PM