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 Complete and Send 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 Offices: The office will be closed Friday, July 3rd for the Holiday, as well as July 16th & 17th. With those dates noted, we are here to serve you Monday, Tuesday, Thursday and Fridays from 8:00-4:30.