Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.

If you are experiencing a dental emergency, be sure to call our practice (410-535-5055) as soon as possible. We are here to help you at any time, on any day. We will make every effort to see emergencies the same day. If you need immediate attention for a dental emergency after hours, call our emergency phone number listed in our voicemail.

Common dental emergencies include:

Broken or cracked tooth/teeth
Broken jaw
Permanent tooth knocked out
Object caught between teeth
Severe toothache

  • Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff.
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