Welcome
Who We Are
Meet Dr. Nelson
Meet The Team
Testimonials
Why Choose Us
Your First Appointment
Sedation Dentistry
Cosmetic Dentistry
Veneers
Whitening
Cosmetic Bonding
Cosmetic Braces
Full Mouth Smile Makeover
Appointment Request
Hours and Directions
More
Procedures
Existing Patients
Make A Payment
CareCredit Financing
Emergency Care
Southtown Dental Care
Dentistry Personalized to Your Needs
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.
Please do not use this form to cancel or change an existing appointment.
Patient Information
Name
Email
Phone
Are you a current patient?
Yes
No
How did you hear about us?
Patient Availability
Preferred day(s) of the week for an appointment?
Any Day
Tuesday
Wednesday
Thursday
Friday
Preferred time(s) for an appointment?
Any Time
Morning
Noon
Afternoon
Evening
Reason For Visit
Please describe the nature of your appointment?
Welcome
Who We Are
Meet Dr. Nelson
Meet The Team
Testimonials
Why Choose Us
Your First Appointment
Sedation Dentistry
Cosmetic Dentistry
Veneers
Whitening
Cosmetic Bonding
Cosmetic Braces
Full Mouth Smile Makeover
Appointment Request
Hours and Directions
Procedures
TMJ (Temporomandibular Joint Dysfunction)
Cleanings & Prevention
Restorations
Composite Fillings
Dental Implants
Porcelain Crowns (Caps)
Tooth Extractions
Fixed Bridges
Inlay Restorations
Onlay Restorations
Periodontal Disease
Periodontal Disease Self-Evaluation
What is Periodontal (Gum) Disease?
Diagnosis
Treatment
Maintenance
Causes of Periodontal Disease
Types of Periodontal Disease
Signs & Symptoms of Periodontal Disease
Mouth - Body Connection
Periodontal Disease and Diabetes
Periodontal Disease, Heart Disease and Stroke
Periodontal Disease and Pregnancy
Periodontal Disease and Osteoporosis
Periodontal Disease and Respiratory Disease
Existing Patients
Make A Payment
CareCredit Financing
Emergency Care