Suresh A. Patel, D.M.D
375 East Main Street, Suite 19
Bay Shore, New York 11706
631-816-2218
631-816-2218
Home
Patient Information
First Visit
Scheduling
Financial Policy
Insurance
Care Credit
Pediatric Dentistry
Privacy Policy
Successful Results
Post-op Instructions
Restoration
Roots Canal
Soft Tissue Management
Crowns and Bridges
Tooth Extraction
Procedures
Tooth-Whitening
Porcelain Laminate Veneers
Inlays/Onlays
Soft-Tissue Management
Endodontics
Soft Tissue Laser
Implant Restoration
Nitrous Oxide
Invisalign
Patient Education
Online Registration
Meet Us
Contact us
Request an Appointment
Dentistry in Bay Shore
Request an Appointment
To request appointment availability, please fill out the form below. Our scheduling coordinator will contact you to confirm your appointment.
Is there a specific date that you would prefer?:
*
Select Date:
What day of the week would you like to come in?:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What time do you prefer?:
*
Select Hours
hour
1
2
3
4
5
6
7
8
9
10
11
12
Select Minutes
minute
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
AM
PM
Patient Name:
*
Email Address:
*
Address:
State/Province:
Zip/Postal Code:
Home Phone:
Cell phone:
Date of Birth:
INSURANCE INFORMATION
Primary Insurance
Subscriber:
ID#:
Name of Insurer:
Phone:
Secondary Insurance
Subscriber:
ID#:
Name of Insurer:
Phone:
Please describe the nature of your appointment:
Security Image:
*
You may click Submit for electronic submission via e-mail or Print the form and bring a copy when you visit Advanced Dental Care Office.
375 East Main Street, Suite 19
Bay Shore, New York 11706
631-816-2218
631-816-2218
info@advanceddentalcare.net
