Request an Appointment

To schedule an appointment with the Lakeshore Dental team, please take a moment to fill out the form below and we will contact you. Thank you!

Name:
Address:
City:
State:
Zip:
Phone Number:
E-mail Address:
 
What service(s) will you need:
Aniti-Anxiety Medication   Implant Dentistry
Teeth Cleaning   Tooth Whitening
Cosmetic Dentistry   Periodontal Therapy
Tooth Replacement   Dentures/Partial Dentures
 
Preferred Apointment Date/Time: 
 
Additional Questions or Comments: