South Rockville Dentist, H. David Allick, D.D.S., P.A., is committed to technical excellence using the latest technology to patients in North Bethesda and South Rockville.
11125 Rockville Pike, Suite 204, Rockville, MD 20852  
   
 

(301) 881-6666

Patient Survey

Please take a moment to complete our survey.  Your comments are welcome and completely confidential. Your input will help us improve our service.  Thank you.

We appreciate you taking the time to complete our survey. Please feel free to comment on your visit as well. Any comments you choose to make are kept strictly confidential and can only help us become better in the future.

Patient Name (optional):
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Date of your last visit (optional):
How was the treatment you received :
How comfortable were you during the treatment you received :
Was your treatment explained to you so that you have a clear understanding of your dental situation :
Were your financial options explained to you? :
How long did you wait before being seated in a room?
Would you refer your friends and family to us? :
Please comment below on how we could make your next visit better and more comfortable.  Thank you.:


 
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New Patient Offer

$99 New Patient Examination,
Cleaning and X-rays

Simply complete the form below by the deadline to take advantage of this offer.

Expires: 05/25/2013


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South Rockville Dentist · H. David Allick, D.D.S., P.A. · 11125 Rockville Pike, Suite 204 · Rockville, MD 20852
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