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 March 4, we are open Monday, Tuesday, Thursday and Friday and closed Wednesday.   For the week of March 11th, we will be open Monday, Tuesday, Wednesday, and Thursday, and Closed Friday and ALL THE NEXT WEEK FOR SPRING BREAK,  March 18 through March 22nd.  We will reopen our regular schedule for the week of March 25, 2019.