Appointments

Appointments

Patient's Name *

 New Patient Existing Patient

Patient's Birth Date*

Address

City:

State

Zip Code:

Home Phone:*

Work Phone:

Cell Phone:

Email Address*:

Preferred Days:

Contact Me By:

Name of insurance:


How did you hear about our practice?

How did you find our website?

Questions/Comments:

Terms of Use
 Yes By checking this box you agree to the Terms of Use listed here:
Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.

By checking this box you hereby agree to hold Dr. Moghaddam, its doctors and affiliates, harmless from any hacking or any other unauthorized use of your personal information by outside parties.

Comprehensive Dental Center
Dr. Jack T. Winchester 3705 Symi Circle Morehead City, NC 28557 252-247-3510
Our practice is conveniently located in Morehead City, NC
Our Hours Monday:8:30 am - 5:30 pm
Tuesday:8:30 am - 5:30 pm
Wednesday:8:30 am - 5:30 pm
Thursday:8:30 am - 5:30 pm
Friday:Closed

Directions to our office