1618 E. Morehead St., Suite 100, Charlotte, NC. 28207
 
(704) 337-8070
 

 
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Rate My Smile

For a cosmetic analysis, simply complete the form below and someone from our dental team will contact you soon.


Do you have concerns about? (please check all that apply)

Gaps or Spaces between Teeth
Color of Teeth
Shape of Teeth
Size of Teeth
Show too much Gum
Symmetry of Teeth
Position of Teeth (crooked or crowded)
Teeth Chipped or Broken
Discolored Restorations (i.e. existing crowns, fillings, bonding)
Front Teeth
Back Teeth
Inflamed or Bleeding Gums



What do you like best about your smile?

What do you like least about your smile?
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Comments or Questions:



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New Patient Offer

Must sign up by: 09/10/2010

The first 20 patients who schedule their initial appointment each month can choose one of the 2 offers below:

$97. Teeth Whitening!
(Regularly $400.00...Save $301.00)

OR

$100.00 Savings Certificate!
Can use toward any out of pocket expenses in our office.
(Perfect for patient without dental insurance)

Call us today or complete the form below.  Thank you.

New Patients Only. This offer cannot be combined with any other offers.



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Advanced Dentistry of Charlotte · 1618 E. Morehead St., Suite 100 · Charlotte, NC · 28207 · (704) 337-8070
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