Patient Registration

Milwaukee Oral Surgery & Implants, Ltd.


You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Registration Form

If attaching an insurance card, please include both sides of the insurance card.

Surgical Expertise. Compassionate Care. Call us Today!
Milwaukee
Milwaukee Office Phone Number 414-257-1161
Mequon
Mequon Office Phone Number 262-241-0398
Glendale
Glendale Office Phone Number 414-964-7109
Menomonee Falls
Menomonee Falls Office Phone Number 262-251-1992
Port Washington
Port Washington Office Phone Number 262-268-7821

Our office hours are Monday through Friday from 8:30 AM - 5:00 PM for all of our 5 office locations.