Request Your Appointment

We Welcome New Patients

Our experienced team is eager to join your child on their dental health journey. To request an appointment at Charlotte Pediatric Dentistry, please use the request form on this page or call us directly at (704) 397-4205

During your child’s appointment, we will take the time to explain our treatment process and answer any questions you may have. We look forward to building the foundation for your child’s lifelong healthy smile!

*Free New Patient Appointment valid only children ages 3 and under

Fill Out the Form to the Right to Request Your Child's Appointment Today

*Please do not submit any Protected Health Information (PHI). This is not a secure or encrypted means of communicating with our offices.

Contact Information

Parent/ Guardian’s First Name*
Parent/ Guardian’s Last Name*
Patient's First Name*
Patient's Last Name*
Email*
Phone*
New or Existing Patient?*
Select Office Location*
How Did You Hear About Us?*
Additional Comments
CAPTCHA