Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Roseburg Office Hours:

Monday: 7:00 AM - 5:00 PM
Tuesday: 7:00 AM - 5:00 PM
Thursday: 7:00 AM - 5:00 PM 

Glide Office Hours:

Wednesday 8:00 AM- 5:00 PM
Friday 8:00 AM- 5:00 PM

Please do not use this form to cancel or change an existing appointment.

Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Where to Find Us

Call: (541) 672-6511

1813 W Harvard Avenue Suite 221
Roseburg, Oregon 97471

Email: normjeddds@cmspan.net