OUR GIFT TO YOU

$1.00 initial exam and consultation

$150.00 value

New Patient please present this certificate at your appointment and recieve a complete consultation, exam and necessary X-rays for $1.00 

(cleaning not included)

 

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May be used for multiple patients

 

Fill in the information and we will contact you.

First Name:
Last Name:
E-Mail Address:
Address:
Address 2:
City:
State:
Zip Code:
Country:
Phone Number:
Best time to call:
Preferred appointment date:
Preferred appointment time:
Additional Comments: