subject_line
702-862-2250
TAKE OUR 20 SECOND QUIZ
Due to the volume of requests we are getting, we have a selection process. Please answer all of these questions if you are interested in getting our All-on-4 Procedure.
How soon do you want your dental implants?
*
Immediately
Within the next 3-6 months
I’m Still Doing My Research
Have you been quoted over $22,000 on full mouth implants or All-on-4 implants before?
*
Yes
No
I am paying with:
*
Cash/Credit Card
Financing
My credit score is
*
680-850
650-679
400-649
I have a co-signer who has a credit score higher than 680
*
Yes
No
I’m entitled to a $50 discount because I have proof of government Medicaid assistance
*
Yes
No
Name
*
Cell Phone
*
Email
*
Anything Else You Want To Tell Us?
By submitting this form you agree to our
Terms and Conditions
.