PLEASE BE ADVISED: This is a REQUESTED appointment and is not scheduled until approved by our office. We will contact you to confirm the date/time requested.  If this is a true dental emergency, please call our office at 718-275-9271.

Contact information

First Name
Last Name

Appointment details

Preferred Date
Alternative Date 1
Alternative Date 2
Reason for Appointment
Comments and Questions
Maximum of 250 characters

Please note that the date and time you requested may not be available. We will contact you to confirm your actual appointment details.