1-888-68-BRAVO 1-888-682-7286
Adults aged 18 and above do not need to provide guardian information.
To request an appointment you can either fill out the form below or fill out the PDF appointment form.
Patient Name *
Age *
Email *
Phone# *
Parent /Legal Guardian 1 Name
Email
Phone#
Parent /Legal Guardian 2 Name
Select Location * Select LocationBluitt-Flowers - Oak CliffDeharo-Saldavar - North Oak CliffGarlandSoutheast Dallas - Pleasant GroveGrand Prairie-E. Carlyle SmithIrving
Dental Insurance DMOMedicaidCHIPOtherMedicareParkland Plan
Requesting appointment for Check upCleaningFillings/CrownToothacheOther