Patient Registration

Online Dentist Registration Form in Greenwood IN

form-checkboxYou may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Patient Registration

Notice of Privacy Practices

Language Assistance Services

Notice of Nondiscrimination

Please call us with any questions.

A New Smile Family & Cosmetic Dentistry Phone Number 317-888-6684

Our Office is located at 1700 W. Smith Valley Rd, Suite C2 Greenwood, IN 46142