Our Clinic Specializes in Dental Implants. Choose what describes you best: *

I need Dental Implant to replace ONE missing tooth

I need Dental Implants to replace Multiple missing teeth

I need extractions and replacing the extracted teeth with Dental Implants

I don't need Dental Implants

New patients are seen at 639 Hempstead Turnpike, Franklin Square, NY 11010. Can you commute to this location *

YES

Have You Ever Had Dentures? *

Yes, Upper Denture Only

Yes, Lower Denture Only

Yes, Both Upper and Lower Dentures

I never had Dentures

If You Ever Had Dentures, what best describes your situation? *

You experience one of the following with your denture: It rocks and moves around, it's hard to talk, it's too bulky, it hurts you when you wear it, you cannot taste food very well, you have too much saliva when you wear it, it makes your lips puff out, your tongue has no space, you don't like to use denture glue,

I am happy with my dentures

I never had dentures

DOES YOUR CONDITION HAVE A NEGATIVE IMPACT SELF ESTEEM AND CONFIDENCE? *

YES

Did Your Condition Affect your Ability to Eat the Food You Like? *

Yes

WHAT IS THE MOST IMPORTANT OUTCOME YOU ARE LOOKING FOR? *

BEST ESTHETIC RESULT

BEST FUNCTION AND LOW MAINTENANCE

BOTH ESTHETICS, FUNCTION AND LOW MAINTENANCE

THE LEAST EXPENSIVE IMPLANT SOLUTION

WHAT IS THE MOST IMPORTANT FACTOR THAT PREVENTED YOU FROM GETTING TREATMENT? *

TIME

MONEY

FEAR

CAN'T FIND THE RIGHT SPECIALIST

How Long Have You Been Missing Your Teeth? ( the longer teeth are missing the more the jaw bone shrinks)

I Still Have Most of My Teeth

1-6 Months

7-12 Months

1+ Year

Have You Had A Dental Implant Consultation With Another Dentist?

YES

How Ready Do You Fee To Do Something About Your Situation?

Somewhat Ready

Very Ready

I Need Something FAST!

Do You prefer to pay the cost of your treatment in full and take advantage of this offer or get a monthly payment plan? *

I PREFER TO PAY IN FULL AND GET THE DISCOUNT

I PREFER A LOW MONTHLY PAYMENT

Which Best Describes Your Current Credit Score?

Below 580

580-699

700+

I'm Not Sure

First Name

Last Name

Phone *

Email *