Main Street Children's Dentistry and Orthodontics of Orange City

Request an Appointment

When applicable, appointments are to be scheduled in advance. During our office hours every effort is made to stay on schedule, however emergencies occur and our dentists & hygienists can be delayed. Please be sure to provide an email and phone where you might be reached prior to your appointment and feel free to call us to confirm your appointment status.

New patients: please be sure to review our new patient information for pediatric dentistry and orthodontics before your first appointment.

Additional Patient:
Date of Birth:
Additional Patient:
Date of Birth:
Additional Patient:
Date of Birth:
Additional Patient:
Date of Birth:
Responsible Party Name:(if different)
Patient Date of Birth*:
Patient Type*:
Preferred Day*:
Preferred Time*:
Email*:
Phone*:
Contact Me*:


Payment Method*:
Questions / Comments:
 
 
What Our Patients Say About Us

“Main Street Children’s Dentistry provided quality service in a timely manner. The dentist and everyone in the office attitude and demeanor was outstanding.”

– Ciara P.