Appointment Request

Easily Schedule an Appointment Here 

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.

Please do not use this form to cancel or change an existing appointment.


Patient Information

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Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Deer Park Dental

21660 Field Pkwy Suite 180, Deer Park, IL 60010

Phone: 847-438-9669