REQUEST APPOINTMENT Request an Appointment with Lane & Associates! Step 1 of 2 50% Select Your Preferred Lane & Associates Office*Please Select Your OfficeAngierBiscoeCary Green Level WestCary St. Charles PlaceCary St. Charles Place (Pediatric Dentist)Cary TryonClintonDunnDunn (Pediatric Dentist)Durham Broad StreetDurham Miami Blvd.Durham Miami Blvd. (Pediatric Dentist)ErwinFayettevilleFuquay-VarinaGarnerGreensboroHamletHendersonHighpointJacksonvilleJacksonville MorganKnightdaleLillingtonMaysvilleMebaneMiddlesexMount AiryMt. OlivePittsboroRaleigh Capt. BlvdRaleigh DowntownRaleigh Harvest OaksRaleigh Neuse RoadRaleigh Ridge RoadRaleigh Wake Forest RoadRichlandsRoseboroSanford Horner BlvdSanford Tiffany Dr.Snow HillSouthern PinesTroyWinston-SalemAre You a New or Existing L&A Patient?*New PatientExisting PatientSelect Your Insurance Type*Please Select Your Insurance TypePrivate InsuranceSelf PayMedicaid To continue please... To continue please... First Name*Last Name*Phone*Email* Reason for Your Visit*Please Select the Reason for Your VisitCleaningChild's VisitFillings or CrownsCosmetic Whitening or VeneersOral Surgery (Wisdom Teeth, Implants, Extractions)Braces or Invisalign® ConsultationTMJ/Jaw Pain TreatmentSnoring/Sleep ApneaUrgent Dental CareOther (Please Explain in Notes Area Below)Preferred Appointment Date* Preferred Time* : HH MM AM PM How Did You Hear About Us?Please Select How You Heard About UsTVRadioDentist ReferralGoogleSocial MediaAccepts My InsuranceNewspaper/MagazineOffice Appearance/ExteriorMail FlyerFair/FestivalNotes for Doctor Δ This iframe contains the logic required to handle Ajax powered Gravity Forms.
