Contact

get in touch

Mon – Wed : 9am – 4pm
Thu : 9am – 3pm
Fri – Sun : Closed

Let us know what you need help with & we’ll contact you to discuss your options.

First Name(Required)

Last Name(Required)

Parent / Guardian Name

Patient Date of Birth(Required)

Phone(Required)

Email(Required)

Reason for Inquiry: (Select all that apply)

Appliance therapy for kids

Frenectomy & tissue release

TMJ therapy

Sleep appliance & laser therapy for adults

Healthy Start Consultation (30 min)

TMD Evaluation (1 hr)

Sleep Well Assessment (30 min)

This field is hidden when viewing the form

User came from

Please share more about what you'd like help with…

1544