The Dental Specialists
Refer or Request an Appointment
Pay Bill Online
Home
About Us
About Us Overview
Why Choose The Dental Specialists
Patient-Centered Care
Clinical Excellence
AAAHC Accreditation
Our Technology
Our Dental Implant Center
News & Announcements
Careers
Continuing Education Seminars
Services
Services Overview
Biopsy
Braces
Comprehensive Pediatric Dental Care
Dental Implants
Dentures
Extractions
Facial Fractures
Full Coverage Restorations / Crowns
Gum Disease (Periodontal Disease)
Gum Recession
Invisalign
Missing Teeth
Periodontal Cleanings (Periodontal Maintenance)
Root Canals
Wisdom Teeth Removal
Specialties
Specialties Overview
Endodontics
Oral Surgery
Orthodontics
Pediatric Dentistry
Periodontics
Prosthodontics
Our Locations
Our Doctors
Patient Resources
Patient Resources Overview
Which Specialist Do I Need?
New Patient Information
Paying for Your Care
Patient Education Videos
Home
About Us
About Us Overview
Why Choose The Dental Specialists
Patient-Centered Care
Clinical Excellence
AAAHC Accreditation
Our Technology
Our Dental Implant Center
News & Announcements
Careers
Continuing Education Seminars
Services
Services Overview
Biopsy
Braces
Comprehensive Pediatric Dental Care
Dental Implants
Dentures
Extractions
Facial Fractures
Full Coverage Restorations / Crowns
Gum Disease (Periodontal Disease)
Gum Recession
Invisalign
Missing Teeth
Periodontal Cleanings (Periodontal Maintenance)
Root Canals
Wisdom Teeth Removal
Specialties
Specialties Overview
Endodontics
Oral Surgery
Orthodontics
Pediatric Dentistry
Periodontics
Prosthodontics
Our Locations
Our Doctors
Patient Resources
Patient Resources Overview
Which Specialist Do I Need?
New Patient Information
Paying for Your Care
Patient Education Videos
Refer or Request an Appointment
Pay Bill Online
Refer a Patient/Request an Appointment
The Dental Specialists makes it easy to refer a patient or request an appointment. Please choose the option below that best describes you:
I'm a doctor referring a patient
Patient Referral
I'd like to request an appointment for myself or a family member
Request an Appointment
Request an Appointment
Request an Appointment
When you need specialty dental care, The Dental Specialists are here wherever you need us. Complete the form below and we'll get your appointment scheduled as soon as possible.
Specialty
*
Required
Select
Endodontics
Oral Surgery
Orthodontics
Pediatric Dentistry
Periodontics
Prosthodontics
Convenient Location
Select
Blaine
Brooklyn Center
Burnsville
Burnsville - Now Open!
Chaska
Coon Rapids / Riverdale
Eagan
Eden Prairie
Edina
Fridley
Lake Elmo / Woodbury
Maple Grove
Roseville
Shakopee
St. Paul
First Name
*
Required
Last Name
*
Required
Parent or Guardian Name (If patient is a minor)
Phone
*
Required
Email
*
Required
Best time to Call
Anytime
Morning
Afternoon
Evening
Preferred Appointment Day/Time (select all that apply):
Day
Monday
Tuesday
Wednesday
Thursday
Friday
Time
Anytime
Morning
Afternoon
Evening
I am a:
*
Required
New Patient
Existing Patient
How did you hear about our practice?
Please Choose One
A Friend
Team Member
Referral from Doctor or other General Dentist
Advertisement
Internet
Other
Message
This form is not to be used for solicitation or advertising purposes. The information you’ve provided will only be used by our team to contact you and will never be released to third parties. For more details, please review our
privacy policy
. By submitting your information to The Dental Specialists, you agree to our website's
Terms and Conditions
. We ask you to review these Terms and Conditions prior to submitting your information.
CAPTCHA