Appointment Request (old)

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our Englewood dental office by phone @ (201)568-6465 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours
Monday: 8:30 to 5:30
Tuesday: 8:30 to 6:30
Wednesday: Closed
Thursday: 8:00 to 6:00
Friday: 8:30 to 2:30
Saturday: 8:00 to 1:00 (Alternating) 

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

*Items in bold are required.
Are you a current patient?

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 are not considered private. Please contact our office by telephone if sending highly confidential or private information.