POLICIES & FORMS


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At Southern Smiles Pediatric Dentistry, our goal is to create a positive, fun and educational experience for our pediatric patients and their parents.  Our desire is to provide all children with a comfortable environment as they receive gentle dentistry.  We view each child as unique and will strive to personalize their dental experience.  We hope to establish a life-long relationship of trust and confidence with our patients and their parents as we provide a positive dental experience and quality care.  Establishing healthy oral habits for all children is very important to us.  We want to make a difference one Southern Smile at a time!

Mission Statement
Hours
Appointment Policy
Financial Policy
Insurance
New Patient Forms
HIPAA Notice of Privacy Policies

MISSION STATEMENT

At Southern Smiles Pediatric Dentistry we are proud to provide the quality, comprehensive care your child deserves.

HOURS

Monday 9-4
Tuesday 9-4
Wednesday 9-4
Thursday  9-4
Friday 9 – 12, Administrative Staff Only

A pediatric dentist is on call daily, weekends, and holidays for emergencies.

APPOINTMENT POLICY

Southern Smiles Pediatric Dentistry reserves a specific time for your child according to their treatment needs and level of cooperation.  As a courtesy, our office will attempt to contact you to confirm your child’s appointment; however, we ask that you assume responsibility for your child’s appointed time.   If you need to reschedule an appointment, we ask that you provide our office with a 24-hour notice so that we may extend the appointment time to another patient.  Multiple (2) broken/missed appointments without prior cancellation notice may be subject to dismissal from the practice.

FINANCIAL POLICY

Fees incurred for dental services are due in full when services are rendered.  For your convenience we accept Cash, Money Orders, Bank Issued Checks, MasterCard, Visa, and Discover.  We do not accept personal checks.  We are a participating provider for Care Credit, our financing partner, which allows you to meet your financial responsibility at the time of service.

INSURANCE

We are happy to assist you in obtaining the maximum benefit from your dental insurance plan.  As a courtesy we will file your dental insurance for you and accept assignment of payment.  Please contact your insurance company for verification of your dental benefits and dentist of choice as most insurance plans only cover a portion of the dental fee incurred.  Some insurance companies recommend a pre-treatment authorization for the dental treatment to be provided.  We will attempt to estimate any expenses prior to your visit to our office.  Please be prepared for any deductible, co-pay, or other expenses at the time of service.  If, for any reason, your insurance company does not respond with financial payment within 45 days post treatment, the balance is due and payable in full immediately by the responsible financial party.

New Dental Insurance Information

NEW PATIENT FORMS

Thank you for choosing Southern Smiles Pediatric Dentistry. Please complete our New Patient Forms prior to your child’s appointment. Our forms are available in Adobe Format. If you experience any problems accessing these forms, please contact our office so that we may assist you in obtaining the forms prior to your visit. We look forward to seeing you soon!
New Patient Forms
Click here to have your records sent to us

HIPAA NOTICE OF PRIVACY POLICIES

Please contact our office if you have any questions regarding our privacy policies.
HIPAA Notice of Privacy Policies

Visit Us Today

We are located at 400 Town Park Blvd, Ste 400 in Evans, GA Next to Cudos2U on Bel-Air Road. We look forward to your visit!
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Appointments

Now Accepting New Patients!

Call us today at 706.288.1100

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Southern Smiles Pediatric Dentistry 400 Town Park Blvd ~ Suite 400 ~ Evans, GA 30809 ~ 706.288.1100
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