Camp Smile provides a full range of preventive and interventional dental procedures for children 0-16 years. Find out more

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Camp Smile Registration Form

Camp Smile cares about your medical privacy.

Our online patient registration form uses secure online protocols, or if you prefer, download and print the pdf registration form and mail to:

Camp Smile Pediatric Dentistry
West Health Medical Building
2805 Campus Drive, Suite 245
Plymouth, MN 55441

If you have questions about this form, please call us at 763 383-1788.

Secure Online Patient
Registration Form