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Personalized & Comfortable Dental Care, with offices in Idaho Falls, Rexburg and Arco.
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(208) 523-5400
Personalized & Comfortable Dental Care, with offices in Idaho Falls, Rexburg and Arco.
208-523-5400
Home
Services
Cosmetic Dentistry
Crowns & Veneers
Dental Implant Placement & Restoration
Dental Laser
Dentures & Partials
Extractions & Minor Surgery
Emergency Services & After-Hours
General Family & Pediatric Dentistry
Wisdom Teeth Removal
Root Canal Therapy
Temporal Mandibular Disorder (TMD)
Teeth Cleaning
Tooth Whitening
White Fillings
X-Rays
Payment Portal
Idaho Falls
Rexburg
Our Team
Office Locations
Idaho Falls
Rexburg
Arco
Contact Us
Contact Us
Request Dental Appointment
Pre-Registration Forms
FAQ’s
Blog
Home
Services
Cosmetic Dentistry
Crowns & Veneers
Dental Implant Placement & Restoration
Dental Laser
Dentures & Partials
Extractions & Minor Surgery
Emergency Services & After-Hours
General Family & Pediatric Dentistry
Wisdom Teeth Removal
Root Canal Therapy
Temporal Mandibular Disorder (TMD)
Teeth Cleaning
Tooth Whitening
White Fillings
X-Rays
Payment Portal
Idaho Falls
Rexburg
Our Team
Office Locations
Idaho Falls
Rexburg
Arco
Contact Us
Contact Us
Request Dental Appointment
Pre-Registration Forms
FAQ’s
Blog
Request Dental Appointment
The form below is provided to request a dental appointment with Eagle Rock Dental Care in
Idaho Falls
,
Rexburg
, or
Arco
.
URL
This field is for validation purposes and should be left unchanged.
Name
*
First
Last
Phone
*
Email
Location
*
Idaho Falls
Rexburg
Arco
Service
*
Cleaning
Consultation
Other
Preferred Date
*
MM slash DD slash YYYY
We will call to confirm availability.
Preferred Time
*
:
Hours
Minutes
AM
PM
AM/PM
We will call to confirm availability.
To help you with your insurance, what Insurance Plan are you covered by?
*
Patient Status At Eagle Rock Dental Care
*
I am an existing patient
I am a new patient
Would You Like Us To Make Appointments For Additional Family Members?
Yes, please.
No, thank you.
Schedule Additional Family Members
First Name
Last Name
Relationship
Service Needed
New or Existing Patient
Preferred Method For Us To Contact You
*
Phone - During Morning Business Hours
Phone - During Afternoon Business Hours
Email
This allows us to confirm your appointment, or resolve any scheduling conflicts.
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