For your convince, Modern Family Dental Care has made all of our new patient forms available to you in an easy to use online electronic format. Simply view, complete, and fill out the form below and click “submit” when you’ve completed it. The information will then be sent to Dr. Taj, ready for your first appointment.
Patient Forms
If you have any questions or concerns about these forms, or would like to receive more information about our services, simply contact us today!
8150 Mt Holly-Huntersville Rd, Suite A Charlotte, NC 28216
Phone: (704) 810-2231
8455 Pit Stop Ct. NW, Ste. 140
Concord, NC 28027
Phone: (704) 931-5530
8505 Davis Lake Parkway, Suite AB-3
Charlotte, NC 28269
Phone: (980) 434-0002
Tooth decay or cavities occur due to the build-up of acid produced by plaque on teeth. If dental plaque is not removed during brushing or
Access to quality dental care at an affordable price.
No insurance needed.