Please complete this form to request an appointment!

Only dates confirmed by Plaza Dental are valid.

To request an appointment, please fill out and submit this form or call us at 952-890-5450. If completing this form, a Plaza Dental representative will contact you within one business day to schedule your final appointment date. To cancel an appointment please do not use this form. Instead, phone our dental office directly and speak with our office personnel to avoid any cancellation fees.

** This appointment form is for online dental appointment requests only! Your appointment is only valid once you receive a booking confirmation from Plaza Dental.