Main Street Children's Dentistry and Orthodontics of Ft. Myers

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 daughter had some cavities that needed filled and both the dental assistant and dentist were very caring and patient with her since she is only 5. Her molars look great now and she has no discomfort or pain.”

– Mariana L.