Schedule an Appointment

Schedule an Appointment

Thank you for your interest in our office! Please call us at (402) 778-0218 to schedule a new patient appointment.

If you prefer, you may submit a request to us using the form below and our treatment coordinator will contact you to schedule an appointment.

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Email: *

First Name: *

Last Name *

Daytime Phone: *

Evening Phone: *

Are you currently experiencing any dental problems?
 Yes NO

If yes, please describe briefly: