Request Appointment

Please complete the form below and click "Request Appointment". Our staff will contact you soon to schedule an appointment.

Are you a new patient?

Patient's Name

Phone Number

Email Address

Preferred Day(s)

Monday
Tuesday
Wednesday
Thursday
Friday

Preferred Time(s)

Morning
Early Afternoon
Late Afternoon

Office Location

How did you find us?

Reason for Appointment

Please provide any other information related to this appointment request:

New Patient Offer

$159 for comprehensive check-up x-rays and cleaning.

Please call for details

Office Hours

Clintondale

Day	Open	To	Close
Monday	8:00am	-	5:00pm
Tuesday	8:00am	-	5:00pm
Thursday	8:00am	-	5:00pm
Friday	8:00am	-	5:00pm

Highland Mills

Day	Open	To	Close
Monday	9:00am	-	6:00pm
Tuesday	9:00am	-	6:00pm
Wednesday	9:00am	-	6:00pm
Thursday	9:00am	-	6:00pm
Friday	9:00am	-	5:00pm

Pompton Lakes

Day	Open	To	Close
Monday	By Appt Only
Tuesday	10:00am	-	7:00pm
Wednesday	By Appt Only
Thursday	10:00am	-	7:00pm
Friday	10:00am	-	6:00pm

Smile A Bit