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P & R Executive Dental Mgmt
P & R Executive Dental Mgmt

Patient Forms

New patient? Please download and fill out the following forms when you come in for your first appointment.

Patient Medical History Form

This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.

Patient Medical History Form
patient information upload.pdf
Adobe Acrobat document [264.6 KB]
Privacy Policy
Privacy Notice.pdf
Adobe Acrobat document [30.1 KB]

Privacy Notice

Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy. This form should also be brought to your first appointment.

Make an Appointment Today!

Call us at: 212 426-8202

 

P & R Executive Dental Management Inc.

2132 Second Avenue

New York, NY 10029

Fax:212-426-6802

Email: prexecutivedental@gmail.com

 

Use our contact form to get in touch.

Office Hours

We are open for appointments from:

  • Monday - Friday

9:00 a.m to 6:00 p.m

  • Saturday

9:00 a.m to 3:00 p.m

 

Ready to schedule an appointment?

Call TODAY at 212 426-8202 or use our contact form.

 

Should you require emergency dental service, please contact our office at 212-426-8202 and we will do our best to schedule an appointment and provide you with the best dental care.

Keep Your Teeth Healthy!

What is the best preventive care for your teeth? Find out how to make your next visit easier and more pleasant.

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