Call Us Today! (252) 447-3100

Appointment Request Form

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or require immediate attention, please contact our practice directly.

Contact information:

Bold fields are required.

Please provide the patient's name

 
Appointment preferences:

Which day(s) of the week are you available?

Which time(s) of the day are you available?


 

 

Great, friendly staff. "Always a good experience! That's saying something for dental work. Staff is very competent and pleasant. I'd recommend them to anyone." — Leanne B.
Got me right in! "I was having problem with a tooth, and they got me in right away. Dr. Coates and his staff are always very professional and caring." — Cheryl B.
Great Experience! "This has been the best dental office I have ever been to. Both the office staff and Dr. Coates are so friendly, and very informative on how to keep my mouth and teeth clean." — Amanda H.
People want to Know...