There is no risk or charge for submitting information here. Think of it as a "first step." We will call you back and answer all or your questions before any scheduling.
West Michigan dentist
Meet the dentist - Dr. B
Make an appointment
Contact dental office
forms for new dental patients
oral health care - tmj therapy, etc.
non-surgical gum disease treatment
xerostomia & dry mouth
cosmetic dentistry
orthodontics, orthotropics & facial orthopedics
play free video games
Notice of Privacy Practices
Make a dental appointment with Dr. Bonofiglo
1.
Who are you making an appointment for?
Full Name
Age
m
yself
Full Name
Age
s
pouse
Children
(skip if none)
Full Name
Age
child
1
Full Name
Age
child
2
Full Name
Age
child
3
What day and time would you prefer for the appointment?
Day (M-Thr)
Time (8:15am-12:00) (1:30-5:00pm)
Mon
Tue
Wed
Thr
8:15am
8:30am
8:45am
9:00am
9:15am
9:30am
9:45am
9:00am
10:15am
10:30am
10:45am
11:00am
11:15am
11:30am
1:30pm
1:45pm
2:00pm
2:15pm
2:30pm
2:45pm
3:00pm
3:15pm
3:30pm
3:45pm
4:00pm
4:15pm
4:30pm
2.
Contact information
Full Name
*
Email Address
Address line 1
*
Address line 2
City State Zip code
*
*
*
Phone number you wished to be contacted at?
Area code Phone number Ext.
*
*
Preferred day and time to call you back?
Day (M-Thr)
Time (8:15am-12:00) (1:30-5:00pm)
Mon
Tue
Wed
Thr
8:15am
8:30am
8:45am
9:00am
9:15am
9:30am
9:45am
9:00am
10:15am
10:30am
10:45am
11:00am
11:15am
11:30am
1:30pm
1:45pm
2:00pm
2:15pm
2:30pm
2:45pm
3:00pm
3:15pm
3:30pm
3:45pm
4:00pm
4:15pm
4:30pm
Copyright © 2001-2002 Eugene L. Bonofiglo, DDS.
All rights reserved, additional copyright information also applies.