Call: (219) 362-5205

Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Consultation Hours:
Monday and Tuesday: 8:00am - 5:00pm
Wednesday: Closed
Thursday: 8:00am - 5:00pm
Friday: 8:00am - 1:00pm
Saturday and Sunday: Closed
24/7 emergency services are available.

Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.
Are you a current patient?


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.):

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

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Office Location

  • La Porte
  • 1112 Indiana Avenue
  • La Porte, Indiana
  • 46350
  • Map & Directions
  • Call: (219) 362-5205
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