Take Our 30-Second Eligibility Quiz.

1

What best describes your current condition?* This field is required.

I have all of my teeth

I'm missing one tooth

I'm missing multiple teeth

I'm missing all of my teeth

2

When was the last time you were seen by a dentist?* This field is required.

Within a year

More than 2 years

More than 5 years

10+ years

3

What is your desired outcome?* This field is required.

Restore my smile

Improve my chewing function

Both

Other

4

Are you interested in a payment plan option?* This field is required.Dental Implant procedures are not covered by insurance. However, many affordable payment plans are available.

Yes. I'm interested in affordable payment plan options.

No. I've been saving for this type of procedure and will not need a payment plan.

5

Which of the options below most accurately represents your current credit score?* This field is required.

(Excellent) 750+

(Good) 650-749

(Fair) 600-649

(Poor) Under 599

6

Financing typically requires a credit score of 650 or higher. Do you have someone who could co-sign for financing if needed?* This field is required.

Yes

No

7

Do you own your own home?* This field is required.

Yes

No

8

Which best describes your current household monthly income?* This field is required.

Under $4,000

$4,000 to $8,000

Over $8,000

10

What's the best way to reach you?* This field is required.

First Name

Last Name

Email

Please enter your phone

Preferred Call Time

11

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