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Sleep Apnea
TMJ Treatment
Pure Power Mouthguard
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I have a current dentist whom I see on a regular basis
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6044 24-Mile Road, Shelby Township, MI 48316
586.739.2155
Request an Appointment
* = Required Fields

Please call me to arrange a consultation appointment to discuss...
Appointment Hours General Dentistry Dental Restoration/Tooth Replacement
Cosmetic Dentistry Gum Therapy Sedation Dentistry
Sleep Apnea TMJ Treatment Pure Power Mouthguard
Dental Implants Other



Name:
*
Email Address:
*
Address:
*
City:
*
State:
*
Zip:
*
Daytime Phone:
*
Evening Phone:
*
Best Time to Reach Me:
*



I have a current dentist whom I see on a regular basis Yes   No
I am missing one or more natural teeth Yes   No
I wear a denture or partial Yes   No
I would like to improve the appearance of my smile Yes   No
I am fearful of dental visits and experience anxiety during them Yes   No
I have all my natural teeth & would like to keep them all my life Yes   No
I would like to discuss/arrange a group presentation on dentistry Yes   No
I am years old and am Male   Female
How did you find our website?


Please enter the code to continue.







6044 24-Mile Road, Shelby Township, MI 48316
586.739.2155

Contact Info

Dr. Ban R. Barbat 6044 24-Mile Road
Shelby Township, MI 48316
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