Request a Dental Appointment

This appointment scheduler is for non-emergency appointments only. If you have an emergency dental problem or prefer to schedule your appointment by phone, please call our office at 919.844.8833.

Appointment Scheduler

Are you a new patient?*
- Yes
- No
If you are a new patient, please complete the New Patient Enrollment Form before your confirmed appointment. There will be a link to that form on the page after you submit your appointment request.
Patient Name*
First Last
Patient Email*
Patient Phone
If the patient is under the age of 18, please provide the parent/guardian contact information below.
Parent/Guardian Name
First Last
Parent/Guardian Email
Parent/Guardian Phone
Select an Appointment
Preferred Appointment Date*
MM slash DD slash YYYY
Time*

: HH

MM
Second Choice Appointment Date*
MM slash DD slash YYYY
Time*

: HH

MM
Reason for visit and any additional information*
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Request a Dental Appointment

Appointment Scheduler

Select an Appointment

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