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812-234-2644
3430 South Fourth Street, Terre Haute, IN 47802
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Root Canal Therapy
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You are here
Home
Make An Appointment
Solutions & Services
General Dentistry
Cold Sore Treatment
Comprehensive Exams
Emergency Dental Care
Gentle, Professional Cleanings
Mouth Guards
Night Guards
Oral Cancer Screening
Periodontal / Gum Disease Treatment
Root Canal Therapy
Cosmetic Dentistry
Invisalign
Veneers
White Fillings
Restorative Dentistry
Dental Implants
Comfort Dentistry
Nitrous Oxide Comfort Dentistry
Oral Medication
Make An Appointment
First Name
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Last Name
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Phone
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Email
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Are you a new patient?
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How did you find us?
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Family, friend, or coworker
Direct Mail
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1-800-Dentist
Location, Sign, Walkin
Groupon, Living Social, Amazon Local or other Daily Deal
Insurance
Yellow Pages
Professinal Referral (another doctor)
Newspaper
Magazine
Billboard
TV
Other
How did you hear about our office?
Is your family, friend or coworker a current patient? We’d love to have their name so we can thank them for referring you to us
Reason for your visit
Dental Consultation
Dental Follow Up
Dental Cleaning
Dental Emergency
Bridge
Crown
Dentures
Filling
Implant(s)
Invisalign Consultation
Root canal
Teeth Whitening
Extraction
Veneer(s)
Wisdom Tooth Problem
Other
Please provide a brief explanation of the reason for your visit
Do you have dental insurance?
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Who is your dental insurance provider
Best day(s) for your appointment
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Monday
Tuesday
Wednesday
Thursday
Friday
Best Time?
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Morning
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Office Hours
Monday:
7:00 AM - 7:00 PM
Tuesday:
7:00 AM - 7:00 PM
Wednesday:
7:00 AM - 6:00 PM
Thursday:
7:00 AM - 7:00 PM
Friday:
8:00 AM - 6:00 PM
