Bradenton, FL and Lakewood Ranch

(941) 241-0558

1906 59th Street West, Suite G

Bradenton, FL 34209

(941) 253-5211

6310 Health Park Way, Suite #240

Bradenton, FL 34202

Find Out If You're A

Candidate For Dental Implants Or The LANAP® Protocol

Answer The Following Questions To Learn More About Our Pricing And Financing Options.

What made you reach out to our office? *

Tooth Pain

Missing Teeth

Insecurities about the way you look

All of the above

What Best Describes Your Condition? *

I Have All My Teeth

I'm Missing One Tooth

I'm Missing Multiple Teeth

I'm Missing All My Teeth

Select All That Apply - Do You Feel That Tooth Loss Has Affected Your: *

Personal Life

Professional Life

Enjoyment of Food

Physical Comfort

Oral Health

Appearance/Self Confidence

Are you currently wearing dentures? *

Yes

What is your timeline to receive treatment? *

Very little, I'm in no rush

Moderate, Within 1-3 months

High, I need help now

How Familiar are you with the "All-On-4" treatment? Scale of 1-10 *

Have you seen another dentist about your condition? *

No, This is my first consultation

Yes, I did not feel comfortable with the other practice

Yes, I'm looking to compare pricing

If this is a second opinion what type of implant solution are you looking for? *

Fixed Full Arch

Implant Supported Denture

Single Implant

Traditional Denture

Not Sure

Dental implants contribute to your overall well-being and are worth the investment. Have you looked into the out-of-pocket expenses associated with this treatment? *

Yes

Given that dental implants are an elective procedure, insurance coverage may only extend to a portion of the treatment costs. Could you please share your current credit score status to better assist you? *

500- 550

551 - 600

601 - 650

651 - 700

701+

I don't know my credit score

Do you have anyone you can bring along with you for the consultation to assist you with this investment? *

Yes

Please Describe your current Oral Health situation and the challenges that you are Experiencing. *

For your convenience, we will send you the customized information in regards to pricing for dental implants via text and email *

Yes send me the information

No, I do not wish to receive information regarding pricing for dental implants

By selecting no, we want to make sure that you are aware that we will not be able to provide you with the pricing and information you have requested regarding Dental Implants, immediately. We will reach out via a phone call but if you would like an email and text regarding pricing, please opt-in below. *

Yes I consent to receive this information

I would like to schedule an appointment to talk in person

I would like to speak to someone via phone call to discuss

I do not want this information

First Name *

Last Name *

Phone *

Email *

Postal Code *

We have two practices located in Bradenton. Are you willing to travel to one of these locations? *

Yes

Which Location Is Most Convenient For You? *

Bradenton - 1906 59th St W Bradenton, FL 34209

Lakewood Ranch - 6310 Health Park Way, Suite #240 Bradenton, FL 34202

Did You Know?

Over half of the U.S. population suffers from moderate to severe periodontal disease (gum disease) yet less than 3% actually receive treatment! Many are worried about the pain or discomfort associated with traditional treatments but left untreated, gum disease can cause tooth and bone loss. The LANAP protocol can quickly eliminate disease-causing bacteria, improving the health of your smile