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Appointment Request

Call (318) 442-4430
The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours: Monday, Tuesday, Wednesday, Thursday: 8AM-5PM  |  Friday: 8AM - 1PM | Saturday and Sunday: Appointment Only 

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 (318-442-4430) if sending highly confidential or private information.

Please tell us what kind of Insurance you have?

Smile With Confidence

As dental professionals it is our priority to provide quality dental care you can trust.

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