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Smoking Cessation
The ADA
Crest Resource Net

LOCATION
[See Map]
2707 Pinedale Road
Greensboro, NC  27408
PH (336) 282-5331
FX (336) 282-0554

We're near the corner of Cone and Battleground.

HOURS
M: 8am - 5pm
T: 8:30am - 5:30pm
W: 8am - 5pm
Th: 8am - 5pm

Our office is closed Fridays and weekends.

Call our office at (336) 282-5331 to speak with one of our friendly staff, email us or fill out this form to scheudle an appointment. We will get back to you at our earliest convenience.

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New Patients!  Download our new patient registration form, print and complete it, and bring it with you to your appointment for faster service.  Download new patient registration form here (28KB) in Adobe PDF format. (Adobe Acrobat Reader required.)

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*Full Name

Business Name

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Phone

Fax Number

*E-mail Address

Method of Contact
Please select the method by which you wish to be contacted.


Preferred Appt. Time

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Comments/Questions

Privacy Statement:
The information which you give in completing this form will be forwarded to the designated party for its use and will not be used by Real Pages for any other purpose or provided by us to any other parties. If you wish information concerning the privacy policy or the designated recipient, you should contact them directly.

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Brian S. Coates, D.D.S., P.A
2707 Pinedale Road
Greensboro, NC  27408
(336) 282-5331

Site design by Mary Geitner of  9-VOLT.com