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Appointment Request

Phillipsburg Dental Care - Appointment Request - Dr. Jason Birnbaum 

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.

Office Hours:

Monday: 9 a.m. – 5 p.m.
Tuesday: 8:30 a.m. – 5 p.m.
Wednesday: 9 a.m. – 5 p.m.
Thursday: 8:30 a.m. – 5 p.m. (November - March), 8 a. m. - 2 p.m. (April - October)
Saturday: 9 a.m. – 1 p.m. ( 1st Saturday in November & January )

Please do not use this form to cancel or change an existing appointment.

Cancellations or change of an existing appointment Must call the Office.

*Items in bold are required.
Are you a current patient?


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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