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Appointment Request

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

Because we respect your time, when you arrive for an appointment, we make every effort to keep your time in the reception area to an absolute minimum. We kindly request that you show us the same consideration by giving us at least two days notice if you need to change or cancel your appointment so we can offer that time to another patient.


To schedule a routine dental exam or an emergency exam, click on Book Now. Please note that routine dental exams do not include a cleaning. If you want to schedule a cleaning along with your exam, please call us at (239) 201-2564 or complete the Request an Appointment Form below.

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COSMETIC AND IMPLANT DENTISTRY IS NOT RECOGNIZED AS A SPECIALTY AREA BY THE AMERICAN DENTAL ASSOCIATION OR THE FLORIDA BOARD OF DENTISTRY. THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE PAY. CANCEL PAYMENT, OR BE REIMBURSED FOR OTHER SERVICES, AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE EXAMINATION, OR TREATMENT. NOT VALID WITH OTHER OFFERS OR 3RD PARTY PAYMENT. OFFER VALID FOR CARD HOLDER. OFFER HAS NO CASH VALUE. GENERAL DENTIST LICENSE #DN18196, PAUL ULIASZ | 3448 CLEVELAND AVENUE | FORT MYERS, FL 33901 | (239) 201-2571. THE FEE IS MINIMUM FEE. LIMITED TIME OFFER. HOURS BY APPOINTMENT.
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