Blair Dentist         Blair Dental Excellence         Cosmetic Dentistry

Charles V Smith DDS
217 East 4th Street = Blair WI = 54616 = (608) 989-2771
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For New Patients of Dr. Smith

Just complete the following form and one of our team members will contact you as soon as possible to schedule a convenient time for 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)

 
 We respect your email privacy.  We promise to never sell, barter or rent your email address to any unauthorized third party.
 

 

Office Hours

=Monday

 9:00 - 5:00

=Tuesday

 9:00 - 5:00

=Wednesday

 9:00 - 5:00

=Thursday

 9:00 - 5:00

=Friday

 9:00 - 5:00
* Other hours available by appointment only

Call (608) 989-2771 Now To Make An Appointment


Dentist
In Blair Wisconsin and the surrounding
Black River Falls - Eau Claire - La Crosse - Winona WI areas.
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