Online Payments

If you wish to pay your bill, please enter basic information about your payment below and click the yellow button.  You will be redirected to PayPal website, where you can securely complete your payment using your credit card or the PayPal account.

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Accepted Forms of Payment

  • In office we accept cash, checks, credit cards with Visa, MasterCard and Discover logo.
  • Online payments can be made with Visa, MasterCard, Discover, and American Express credit cards or as the PayPal transfer.

Amount of Payment

  • If you have insurance - we will request the benefits predetermination from your insurance carrier, which will ascertain the amount covered by your dental plan.  At the time of service you will pay only the required copayment.  After the service, we will submit claim to your insurance.  You will be billed for the remaining balance not covered by your dental plan. If your insurance company does not submit payment within 90 days, you may be billed for the total cost of the service.
  • If you do not have insurance or the particular procedure is not covered by your plan - you are responsible for the full cost of the treatment.  The payment is expected at the time of service.  For general pricing please contact our office.  The precise estimate often requires consultation with the dentist.
  • For all procedures that require lab work (crowns, bridges, dentures, posts, night guards, etc.) a 50% downpayment is required before the impressions are sent to the lab.  If you have dental insurance, your copayment for the lab work is required at that time.

Other Fees

  • We reserve the right to charge $30 for "no-show" appointment if you don't contact our office to cancel or reschedule your visit at least 24 hours ahead.
  • There is $30 fee for the checks returned due to insufficient funds or stop payment.


or click the phone number to request call‑back during our business hours

1120 East Central Road
Arlington Heights, IL

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Patient Forms

Before coming with your first visit, please download and complete our forms in the comfort of your home.

Make a Payment

You can pay with a credit card or, if you have PayPal account, you can pay directly from your checking account.

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