Request an Appointment

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly. Required fields are marked with asterisks (*).

Patient Information

Have you visited our office before? *:

What is the reason for the appointment? *:

Confirmation

How do you prefer to be contacted? *:

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Village Dental

523 Park Drive
Kenilworth, Illinois 60043

(847) 251-8990

HOURS

Monday 8:00 AM - 2:00 PM
Tuesday 8:00 AM - 2:00 PM
Wednesday 8:00 AM - 2:00 PM
Thursday 8:00 AM - 2:00 PM
Friday 8:00 AM - 2:00 PM
Saturday 8:00 AM - 2:00 PM
  (2 per month)