Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.  Our fax number is 515-440-1184.

Note to General Dental Office:    For the week of November 19, we will be open Monday and Tuesday, and closed Wednesday, Thanksgiving Day and Friday.  We will reopen November 26th to serve you.  For the weeks of December 3, 10, and 17, we will be open our regular days including Monday, Tuesday, Thursday and Friday.  We will be closed the week of December 24, ALL WEEK.