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Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone at 336-619-4234 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

This form is not for soliciting and is only for existing or potential patients.


*Items in bold are required.
Are you a current patient?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Office Location

  • Lexington
  • 5569 Old U.S. Hwy 52
  • Lexington, North Carolina
  • 27295
  • Map & Directions
  • Call: (336) 619-4234