PATIENT INFORMATION

Contact Us Today!

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Full Name:

Email Address:

Phone:


I am interested in:
Scheduling an Appointment
Bonding
Porcelain Veneers
Dental Implants
Teeth Whitening

Best Time for Appointment:
Morning
Afternoon

Preferred Day of Week:
M T W TH F S

Comments/Questions:

We monitor our appointment requests several times a day and will usually reply within one business day during open hours.

Insurance Information

At Acton Dental Associates we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures.

Patients With Dental Insurance

To assist in obtaining maximum reimbursement from your insurance carrier, we will gladly prepare and send your insurance forms for you.  Please bring your insurance identification card, form and booklet with you on your first visit.  Please remember that you, not your insurance company, are responsible for the full payment of any treatment.  Dental insurance is not designed to be a full payment insurance.  Patient co-payment is almost always required.
 
You may pay your bill in full, and we will gladly process your claim form.  Your benefits would then be paid directly to you from your insurance company.
 
You may assign payment to us and we will estimate the approximate difference.  This co-payment amount is due the day dental services are rendered.  If the estimate is different than anticipated, we will bill you for the balance or send you a check for any overpayment.  We are a participating member of the Delta Dental and BlueCross/Blue Shield Dental Insurance Plans.
 
Our ability to electronically submit claims to most dental insurance companies eliminates the patient's burden of individual claims submission.  Electronic filing leads to quicker and more accurate benefits for the patient.  Please call our insurance coordinators for more information about how we can maximize your benefits.