Schedule an appointment

It’s easy to schedule an appointment with Carolina Pediatric Dentistry. Simply fill out this form, and we will contact you within two business days.

Parent’s name *
Parent’s name
Child’s name *
Child’s name
This would be the child for whom you wish to make an appointment.
Phone *
Phone
Address
Address
If you are already a patient of Carolina Pediatric Dentistry, you do not need to complete this section.
Please provide any additional information that would be helpful to Dr. Green.
New patient? *