New Patient Information & Online Forms

Complete New Patient Adult Form Online Complete New Child Form Online

We know you have many choices in choosing the right dentist for you. We are conveniently located on the corner of Greenhouse Road and I-10. Our brand new facilities include a brand new Kodak digital panoramic and cephalometric X-Ray machine, in office whitening, Digital intra-oral camera, and Diagnodent, a state of the art cavity detection system.

For your comfort we offer two flat screen LED televisions in every operatory; soda, water, juice and coffee refreshments, and a wide assortment of treats at our snack bar; and updated magazines in our waiting area!

Download the following files and bring them with you on your first visit:

– Click image/link to download form –

At Pure Smiles, we offer a full range of general, cosmetic and advanced family dentistry.

Payment Options

We are in network with most major PPO insurances and discount plans. We accept Visa, Mastercard, American Express, and Discover. For major dental treatment plans, we provide affordable payment plans and offer financing through care credit. Please apply at or call (800) 677-0718.

At our office, we will do everything possible to help you afford the dental care you and your family needs.