Patient Registration

Online Forms You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Please Select Which Office This Visit is For:

ORAL SURGERY AND DENTAL IMPLANT CENTERS

Athens Office: 740 Prince Avenue, Building 1-A, Athens, GA 30506 • Phone 706-549-9711 • Fax 706-549-3766
Atlanta/Buckhead Office: 3580 Piedmont Rd NE, Ste 207, Tuxedo Center, Atlanta, GA 30305 • Phone 404-233-5385 • Fax 404-237-5460
Conyers Office: 1463 Klondike Road, Suite C, Conyers, GA 30094 • Phone 770-483-9692 • Fax 770-922-8603
Covington Office: 7135 Floyd Street, Covington, GA 30014 • Phone 770-787-2444 • 770-787-9513
Decatur Office: 5243 Snapfinger Woods Drive, Suite 106, Decatur, GA 30035 • Phone 770-981-9400 • Fax 770-987-8720
Monroe Office: 307 S. Broad Street Monroe, GA 30655 P.O. Box 825 • Phone 678-345-1014 • Fax 678-345-1018
Roswell Office: Opening in January! 10930 Crabapple Rd., Suite 160 Roswell, GA 30075 • Phone 678-781-0050 • Fax 678-533-0410
Snellville Office: 2386 Clower Street, Snellville, GA 30078 • Phone 770-979-9500 • Fax 770-978-2880
Stockbridge Office: 225 Country Club Drive, Stockbridge, GA 30281 • Phone 678-565-0719 • Fax 678-565-3894
Tucker Office: 4915 LaVista Road, Tucker, GA 30084 • Phone 770-934-1907 • Fax 770-493-4900

Patient Registration

Please Select Which Office This Visit is For:

Patient Information

ORAL SURGERY AND DENTAL IMPLANT CENTERS