Register Username* Password* Repeat Password* Office Location* CHOOSE LOCATIONWEST COLUMBUSLOGANASHLANDEAST COLUMBUSZANESVILLEMARIONSPRINGFIELDAKRONDAYTON Name Suffix* Sr.Jr. First Name* Last Name* Date of Birth Age Patient Type*New PatientExisting Patient Phone Number* E-mail* Confirm your email address:* Address Name Area Zip Code State Name City Name Primary dental insurance* Secondary Dental Insurance* I allow the website to collect and store the data I submit through this form.*Subscription PlansComprehensive Plan - $199 2 exams (any type) 1 Panoramic Xray (if needed) 1 Set of Full Mouth Xrays (if needed) 1 set of Bitewing Xrays (six months after the Full Mouth Xrays if needed) 2 cleanings (per year) 20% off All treatments 10% off All Orthodontic treatments Learn More Sign Up Basic Membership Plan - $99 1 exam (any type) 1 panoramic Xray (if needed) 1 set of Full Mouth Xrays (if needed) 1 cleaning (per year) 20% off All treatments 10% off All Orthodontic treatments Learn More Sign Up Automatically renew subscriptionProcessing. Please wait...Send these credentials via email.