M: 7:30am – 5:30pm T/TH: 7:30am – 4:30pm W: 9:00am – 8:00pm F: 7:30 – 12:30pm

(703) 815-0775
14245f Centreville Sq Centreville, VA 20121

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New Patient Info

For your first office visit to Centreville Dental Wellness Center:

Thank you for choosing Centreville Dental Wellness Center for your dental care, and we look forward to seeing you.

All new dental patients are asked to complete our new patient form prior to their first appointment. Please download the form and bring it with you completed to the office for your first appointment.

New Patient Information Form
Medical History Form
Dental History Form
Financial Policies
HIPAA
Notice of Our HIPAA Privacy Practices
Sleep Apnea Screening

If you have dental insurance…

We will gladly process your claim but we request that you pay your estimated portion when services are rendered.

Cancellation Policy

We reserve the right to charge for appointments cancelled or broken without 48 hours advance notice.

We look forward to the opportunity to serve you and if we can be of service, please refer to our Patient Library section, or if you would like to request an appointment, please contact us by email.

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