Appointment Form

Use the form below to send an appointment request to our office or call us at (918) 331-0016. Our hours are Monday – Thursday 7:30AM – 5:00PM, Lunch from 1-2pm We will contact you back as soon as possible to verify your appointment.

Patient Name *
  First Name Last Name
Patient Name
  First Name Last Name
Email *
Daytime Phone *
Preferred Days *
Alternative Phone *
Time *
How did you hear about our practice?
How did you find our website?
Tell us about your dental needs *