St Louis Dentist    Gary B Wiele DDS    Cosmetic Dentistry   
    Gary B Wiele DDS

Please call (888) 803-1465 to schedule an appointment.

For New Patients of Dr. Wiele


Just complete the following form and one of our team members will contact you as soon as possible for a convenient time for your first appointment.

By providing the below information, or by calling (314) 726-2265, you will receive our comprehensive exam that includes an examination of your teeth, gums, joints, and bite; an ear to ear X-ray of both jaws, four cavity detecting X-rays, any necessary photography, and a discussion of any findings.  You will receive this for a low $125.00, compared to the standard $271.00.  The catch is it must be prepaid by check or credit card when you book the appointment.

You might ask yourself, “why on earth would a doctor of Dr. Wiele’s caliber offer such a deep discount?”  It tells us a lot about you.  It tells us that you are someone that will be there for your appointment.  We value that quality in a person so much that we are willing to assume some of the financial responsibility of your first appointment.


Please provide the following contact information:

Title & First name

Last name

Middle initial

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Work phone

Home phone

Call me at

Best time is

How did you hear
about us?

FAX

E-mail

Referred by (Mrs. Jones)

 

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Dentist
In St Louis Missouri and the surrounding
Kirkwood - Webster - Ladue - Clayton MO areas.

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