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Dental Care Kids
Pediatric & orthodontic dentists in Stamford, CT.
Why DCK?
COVID-19: We Are the Safest Office in CT
We Love Kids!
Kids Activities
Testimonials by Patients
Latest Technology
Contact Us
Appointment Request
Our Team
Join our Team
Pediatric Dentists
Dr. Gabrielle Sykoff
Dr. Durgesh Kudchadkar
Dr. Ariel Ginsberg
Dr. Fredrick Harris
Dental Care Teens
Dr. Sadaf Enayati
Orthodontists
Dental Hygienist Team
Patient Resources
Pay Bill Online
Appointment Request
First Visit
Office Tour
Dental Topics
Dental News
General Topics
Teen Dental Topics
Early Infant Oral Care
Prevention
I.V. Sedation
More Dental Services
Orthodontics
Orthodontic Services
Orthodontic Terms
Orthodontic Care
Orthodontic Emergencies or Problems
Orthodontics: Before & After Photos
Adult Dentistry
203-883-4433
Contact us
Why DCK?
COVID-19: We Are the Safest Office in CT
We Love Kids!
Kids Activities
Testimonials by Patients
Latest Technology
Contact Us
Appointment Request
Our Team
Join our Team
Pediatric Dentists
Dr. Gabrielle Sykoff
Dr. Durgesh Kudchadkar
Dr. Ariel Ginsberg
Dr. Fredrick Harris
Dental Care Teens
Dr. Sadaf Enayati
Orthodontists
Dental Hygienist Team
Patient Resources
Pay Bill Online
Appointment Request
First Visit
Office Tour
Dental Topics
Dental News
General Topics
Teen Dental Topics
Early Infant Oral Care
Prevention
I.V. Sedation
More Dental Services
Orthodontics
Orthodontic Services
Orthodontic Terms
Orthodontic Care
Orthodontic Emergencies or Problems
Orthodontics: Before & After Photos
Adult Dentistry
Appointment Request
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Appointment Request
The form below is to REQUEST an appointment, we will contact you to confirm your appointment with the information you provided us. If this is an emergency we advise you to call us directly.
203-883-4433
Your Information
Name
*
First
Last
Address
Street Address
Address Line 2
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Armed Forces Americas
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First time at Dental Care Kids
*
Yes
No
Email
*
Email Consent
*
Do we have your permission to send you occasional correspondence on informative dental topics as well as reminders of your appointment via email? You may opt out at any time.
Yes
No
Mobile Phone
Mobile Phone Consent
Do we have your permission to send you occasional correspondence on informative dental topics as well as reminders of your appointment via SMS? You may opt out at any time.
Yes
No
Home Phone
Patient Information
Patient Name
*
Age
Gender
Male
Female
Appointment Information
Preferred Appointment Date
MM slash DD slash YYYY
Choose a Time
Morning
Afternoon
Anytime
Reason for Appointment
Exam, Cleaning and X-Ray
Toothache or Other Emergency
Recommended Treatment
Other
How did you hear about us?
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Other
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