create counter
accessibility ACCESSIBILITY

The first step towards a beautiful, healthy smile is to schedule an appointment. Please call us at 336-236-9497 or complete the appointment request form below. You may also email us at: nclexingtondental@gmail.com to schedule an appointment.  Our scheduling coordinator will contact you to confirm your appointment.

IF YOU ARE A NEW PATIENT, PLEASE CLICK ON THE PATIENT FORMS TAB ABOVE TO DOWNLOAD YOUR REGISTRATION FORM.  FILL OUT BOTH PAGES OF THE FORM AND EITHER EMAIL OR FAX US YOUR COMPLETED FORM ALONG WITH A COPY OF YOUR INSURANCE CARD BEFORE YOUR APPOINTMENT.  OUR FAX NUMBER IS: 336-236-9555.

If you are UNABLE to keep your appointment, please contact our office at least 24 hours before your appointment time.  A $25 no-show or cancellation fee may apply if you fail to timely notify us of your cancellation.

 

Office Hours

Monday:  9:00-5:00
Tuesday: 9:00-5:00
Wednesday: 9:00-5:00
Thursday: 9:00-2:00 



Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):
 
 

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.