Main Street Children's Dentistry and Orthodontics of Cape Coral

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.

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


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

“My son was PETRIFIED of having his teeth cleaned and examined until he met Jessica in the Cape Coral office. She is so wonderful with my son and completely puts him at ease and makes each visit better and better. She is such a HUGE asset to this office. The entire staff including Dr. Boucher are superb!!!”

– Michele P.