118 S. Main St, Canastota, NY 13032
1810 Erie Blvd, Syracuse, NY 13210
Patient Registration Forms
1. Follow the link and fill out the PATIENT REGISTRATION FORM and Health History.
2. You will upload a picture of your dental AND medical insurance. Type your full name in the subject line of the email.
3. Urgent Smiles Solutions Triage Team will charge your credit card $50 prior to your virtual TeleDentistry visit or in-office appointment. The remainder of the service fees will be charged to your credit card after all services are rendered.
4. If you have dental insurance, the Administration team will file the claim for you and assign the insurance payment to you and to be mailed to your home address.
Is this service covered by dental insurance? The provided dental services are considered for coverage by most insurance plans, depending on your individual plan and benefits the benefits vary. We do not accept Medicaid Insurance Plans at this time. If you are interested in a pre-determination, please fill out the INQUIRY FORM and we will be able to assist you.