‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍‍To make an appointment with our office serving Fort Myers, Cape Coral, Bonita Springs, Sanibel, Fort Myers Beach, Estero, and surrounding areas, please complete the form available on this page. We also welcome you to contact our front office team directly at (239)936-5252 during our normal office hours.

Office Hours
Monday - Wednesday: 8am – 5pm

Thursday: 8am - 3pm

For an after hours dental emergency please call our Fort Myers dentist office at 239-936-5252. A member of our dental team will have their personal cell phone listed for your convenience. Please feel free to contact that number for timely assistance. Our number one priority is for each patient to have access to quality care whenever it is needed.

Whether you need a tooth cleaning, a cosmetic consultation, or a dental emergency exam; schedule your dental appointment with our Fort Myers dentist today! Calling our office is the first step towards a beautiful, healthy smile! This will also allow you to begin a long term, trusting relationship with our Fort Myers dentist! Our dental office is happy to accept new patient. We are happy to treat any new patient’s needs and concerns. We can start a new patient on a plan for preventative care or address any problem areas through restorative dentistry to prevent further breakdown of the mouth!

Emailing our office is not a confirmation of a scheduled dental appointment. A member of our team will give you a call upon receipt of this request. They will confirm if your requested time is available with our dentist. If not, they will work with you to schedule your next best availability.

Office Locatio‍‍‍n

7630 Cambridge Manor Place

Fort Myers, Florida 33907

New Patient Forms

Please print ALL forms below, complete them, and bring them to your first appointment.

Request Your Appo‍‍‍intment Today

Because you Deserve a Sig‍‍‍nature Smile!

Airway Questionnaire

Cancellation Policy

Dental History Form

‍‍New Patient Registration

Medical History

‍‍‍‍‍‍Agreement to Receive Electronic Communication

General Consent

‍‍HIPAA Authorization‍‍‍

HIPAA Consent

Photo Consent