New Patients

New Patients Form

Instructions: Open the Fillable Patient Form and fill in all the fields required. After filling

in all the necessary information, download the PDF and send it to us at

*Our ONLINE PAYMENT system is currently experiencing an outage and credit card payments via the website are temporarily disabled.

If you would like to make a payment on your account, please contact the office directly at 636-928-4888.

Direct payment by debit or credit as well as financing options are available. Please choose the option below to submit your payment.

We are contracted preferred providers for 98% of insurance companies. We'll happily handle the paperwork as well!

(636) 928-4888

groschdentalllc@gmail.com

2408 Hwy 94 South Outer Rd,

St. Charles, MO 63303

(636) 928-4108

MONDAY - THURSDAY

7 AM - 4 PM

Closed Daily for Lunch:

11 AM - NOON

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