New Patients - Make an Appointment

Please provide us with the following information. We will contact you within 24 hours to schedule an appointment.

*Title:

*First name:

Middle initial:

*Last name:

I like to be called: (Sample: Mrs. Jones or Jennie)

*Address 1:

Address 2:

*City:

*State/Province:

*ZIP/Postal Code:

*Email:

Work or cell phone:

*Home phone:

Fax:

I prefer:

Call me:

The best time is:

*How did you hear about us:

Referred by:

Do you have an immediate concern?

Would you like to subscribe to our newsletter?

Our email policy - We promise never to sell, barter or rent your email address to any unauthorized party.

Financial Arrangements

Our goal is not to let expense prevent you from benefiting from the quality of care you desire and need.

50th & France Dental Care

3939 West 50th St.

Suite 210

Edina, Minnesota 55424

General Info: (952)922-5561

50th & France Dental Care, 3939 West 50th St., Suite 210, Edina, MN 55424 - (952)922-5561