Book An Appointment

Thank you for choosing Dentistry At The Modern. To request an appointment, please fill in the information below and our staff will be in touch to confirm a date and time for your visit. For emergencies or urgent care requests, please call our office at 416-988-7960.

Name(Required)

First Middle Last

Email(Required)

Enter Email Confirm Email

How would you like us to call you? (Check all that apply.)(Required)

Mobile Phone

Home Phone

Work Phone

Mobile Phone(Required)

Home Phone(Required)

Work Phone(Required)

Date of Birth (mm/dd/yyyy)(Required)

Is this your first visit?(Required)

Yes, I'm a new patient

No, I'm an existing patient

Please describe your reason for this visit:

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.