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.

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.

Debra S. Palmer, DDS
Tiffany J. Smalkoski, DDS
Creating Beautiful Smiles

Racine Dentist, Dr. Debra Palmer is dedicated to excellence in general dentistry such as cleanings, restorations, and maintenance.

2021

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Our Office

4425 Taylor Avenue, Suite 3Racine, WI 53405Get Directions262.554.9055

2021

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