Patient Registration

Please click on the link below to complete the patient registration.

PLEASE NOTE, ALL FORMS WILL BE SIGNED IN OUR OFFICE.  Please complete and submit all forms without signatures.

Your information is important to us and, as such, we have taken all necessary steps to ensure that your data is secure.

If you have any questions please contact our office.

Patient LoginNew Patient Questionnaires

Are You Ready to Smile With Confidence Again?

Contact us with any questions or to schedule an appointment to reclaim your smile today!

Call us: 248-589-2021 Request An Appointment