Request An Appointment | Serenity Dental of Mobile

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(251) 479-5157

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Request An Appointment

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Appointment Form

Request An Appointment - Form

What is the reason you need a dental visit?*

Checkup & Cleaning

Specific Treatment

Urgent Issue

If you selected Specific Treatment or Urgent Issue, please describe it

What dental service would you like to discuss on your visit?

Dental Bridges

Dental Bonding

Dental Veneer

Dental Crowns

Dental Implants

Teeth Whitening

Cleaning

Teeth Cleanings for Kids

Sedation

Tooth Sensitivity Treatment

Sports Guards

Tooth Extractions

Oral Cancer Screening (complimentary at every exam)

TMJ Therapy

Full Mouth Reconstruction

Nitrous/Laughing Gas

Other

Are you experiencing any kind of tooth pain that would prevent you from your First Visit Cleaning?

Yes

What is your name?*

Date of Birth

What is the best phone number to reach you at?*

What is your email address?*

Would you like to schedule an appointment for another family member? If so, please type in their name

Free Text

We are in-Network with most insurances companies with the exception of Medicaid and Delta Dental. We apologize for the inconvenience.

To expedite your scheduling, please upload pictures of your insurance card below (Optional):

Insurance card front

Upload FRONT of Card Here

Insurance card back

Upload BACK of Card Here

Thank you for contacting us.
We will get back to you as soon as possible.

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(251) 479-5157

116 S Florida St, Mobile, AL 36606

serenitydentalofmobile@gmail.com

Serenity Dental Of Mobile

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