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Appointment Request

Schedule an Appointment with our Dentist in Rockville!

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.

**To better serve our patients, insurance payments are calculated prior to each appointment and patient balances are due on the date of service.


*Items in bold are required.


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.





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Dr. Richard G. Wyne, DDS
4110 Aspen Hill Rd Suite 310 Rockville, MD 20853
Phone: (301) 871-7100 URL of Map