Online Payment

We understand sometimes you are unable to stop by our office or mail in a payment. You can always call our office to pay by phone or us the below form. By filling out the below form to make your payment, you are agreeing to let us run your credit or debit card for the amount you enter. You also are entering a card that belongs to you and that you have permission to run for the balance you indicate. Most online credit card transactions could take up to 48 hours before being processed. A receipt will be mailed to your home mailing address. If you do not see a charge within 48 hours of sending this form, please contact the office. If you do not receive your receipt within a week of sending this form please let us know. Thank you for trusting us with your dental needs and we look forward to seeing you at your next appointment.

Please fill out the form below to complete your online payment.