Providing Services for Binghamton, Johnson City, Vestal, Owego, Elmira, Ithaca and Surrounding Communities

Contact

Dental Solutions of Binghamton

Call us to make an appointment

Contact Form

Name

This field is for validation purposes and should be left unchanged.

Patient Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Preferred Contact Method(Required)

Are You a New or Existing Patient?(Required)

Reason for Contact(Required)

How soon would you like to be seen?

What City do you call home?(Required)

City Country

Are you interested in learning about Hybridge dental implants?

Please select seminar date(Required)

Best Time to Contact You?(Required)

Please let us know if you are missing teeth, have loose or failing teeth, have dentures that move or are uncomfortable, experiencing difficulty chewing certain foods, or are exploring long-term solutions, gathering information, or to obtain a second opinion(Required)

Please share any details about your dental concern.

Have you previously been told you need dental implants or full mouth reconstruction?(Required)

How did you hear about us?(Required)

Which doctor referred you?(Required)

Insurance Information

Do you have Dental Insurance?(Required)

Please list your insurance provider:(Required)

Insurance Notice:
Insurance-Independent Dental Care
Dental Solutions of Binghamton is an insurance-independent practice, allowing our doctors to recommend the treatment that is best for your long-term oral health—not the limitations of insurance plans. We provide clear treatment options, help you maximize any available insurance benefits, and offer financing options to make care affordable.

Additional Notice:
Hybridge (Full Arch / Hybridge Implant) procedures are not Medicaid-covered benefits.

Insurance Disclaimer:
Payment is due at the time of service. As a courtesy, we submit claims to most commercial dental plans, with reimbursement sent directly to the patient. Dental Solutions of Binghamton does not participate with Medicaid or Medicare.

HIPAA Consent Disclaimer
By submitting this form, you consent to being contacted by Dental Solutions of Binghamton.

CAPTCHA