The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office preferrably by phone during business hours for the most prompt response at 212.832.0808.  You may also fax or complete the appointment request form below. Our scheduling coordinator Karen or Julie will contact you to confirm your appointment.

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


*Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Email:
Phone:  
Are you a current patient?
Best time(s) to call?

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, or the internet in general, should not be considered completely private due to the internet privacy limitations. Our office will always keep your matters completely private and secure. Please contact our office by telephone if sending highly confidential or private information.