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.

HOURS:

Monday 8-4
Tuesday 11-7
Wednesday 11-7
Thursday 8-4


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

Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information. By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message from Daniel D Seitz DDS PC. Message frequency may vary. Message & data rates may apply. Reply STOP to opt-out of further messaging. Reply HELP for more information. See our Privacy Policy.