How Many Teeth Are You Looking To Replace *

All of them

1-3 Teeth

4-6 Teeth

Full Upper Set

Full Lower Set

What Type Of Replacement Options Are You Looking For? *

Teeth that are permanent meaning they don't come in and out.

Teeth that are removable.

Are You Currently Experiencing Pain? On The Scale Of 1-10 How Much Pain Are You Experiencing *

7-10 (Very Painful) Emergency

4-7 (Moderately Painful) You need to be seen soon

1-4 (Low Pain) Lets hurry before it gets worse

Have You Ever Been Told You Do Not Have Enough Bone? *

Yes (Don't worry, we have many options other dentists don't have, to get you permanent teeth)

We are excited to assist you on your journey to a healthier smile. To personalize your experience and provide the best possible care, we kindly request that you upload a recent photograph of your smile. (Optional)

Dental Implant procedures are not always covered by insurance. However, many affordable payment plan options exist. Are you interested in a payment plan option?

Yes (We can help you determine what options you have)

No Thanks I have that part figured out

I have Medicare

I have Medicaid

Payment Plans Are Available Based On Credit Approval Of The Patient Or A Co-Signer. Which Option Describes Your Credit Score? *

700+ (Very Good)

650-700 (Good)

600-650 (Still Possible depending on need)

600 or Less (Might Be Difficult)

I have a Co Signer that will help me qualify

Monthly Budget

$50-$100 Per Month

$100-$250 Per Month

$250-$500 Per Month

$500-$750 Per Month

First Name *

Last Name *

Phone *

Email *

Address *

City *

State *

Postal code *

I agree to receive SMS and emails for the abovementioned number by providing my phone number. I also agree to the disclaimer provided by the company.