How Many Missing Or Broken Teeth Do You Have?
*
All
6+
4-5
3 Or Less
Do You Have Several Loose Teeth Or Been Diagnosed With Periodontal Disease?
*
Yes
No
What Is Your Age?
*
60+
50-59
40-49
<40
Do you currently have any of these dental solutions?
*
Denture or Partial Denture
Bridge, Crown
Dental Implant
None of the above
How Long Have You Been Missing Your Teeth? (The longer teeth are missing the more the jaw bone shrinks)
*
I Still Have Them
1-6 Months
7-12 Months
1+ Years
Are You Currently Unable To Eat Certain Foods Or Have To Modify The Way You Chew?
*
Yes
No
Are You Currently Trying To Find Relief From Any Kind Of Pain Or Discomfort?
*
Yes
No
Are You Currently Experiencing A Lack Of Confidence In Social Situations or Find Yourself Hiding Your Smile?
*
Yes
No
Have You Had A Dental Implant Consultation With Another Dentist?
*
Yes
No
How Ready Do You Feel To Do Something About Your Situation?
*
Somewhat Ready
Very Ready
I Need Something FAST!
Dental Implant procedures are not covered by insurance. However, many affordable payment plans are available. Are you interested in a payment plan option?
*
Yes. I'm interested in affordable payment plan options
No. I've been saving for this type of procedure and will not need a payment plan
National averages for dental implant procedures can range from $22,000 to $55,000. Payment plans start at $300/mo. Would you like to see if you qualify for payment plans, or still continue without?
*
Yes, please tell me if I might qualify for a payment plan
No, I don't need a payment plan
Payment plans are available based on credit approval of the patient or a co-signer. Which best describes your credit?
*
(Poor) Under 660
(Fair) 660-699
(Good) 700-739
(Excellent) 740+
Which best describes your current monthly income?
*
Under $5,000
$5,000 to $8,000
Over $8,000
Do you live in near Baltimore, MD?
*
Yes
No
What region of the country do you live in?
*
Midwest Region (IL, MI, MN, OH)
Northeast Region (MD, NY, PA)
Southeast Region (FL, GA, TN, VA)
Southwest Region (AZ, TX)
West Region (CA, CO, NV, UT, WA)
None of the above
Midwest Region: Which Nuvia location are you closest to?
*
Arlington Heights, Illinois
Detroit, Michigan
Dublin, Ohio
Minneapolis, Minnesota
None of the above
Northeast Region: Which Nuvia location are you closest to?
*
Baltimore, Maryland
Chevy Chase, Maryland
Philadelphia, Pennsylvania
Pittsburgh, Pennsylvania
Westbury, New York
None of the above
Southeast Region: Which Nuvia location are you closest to?
*
Fort Lauderdale, Florida
Jacksonville, Florida
Miami, Florida
Orlando, Florida
Tampa, Florida
Alpharetta, Georgia
Marietta, Georgia
Nashville, Tennesee
Alexandria, Virginia
None of the above
Southwest Region: Which Nuvia location are you closet to?
*
Phoenix, Arizona
Austin, Texas
Dallas, Texas
Fort Worth, Texas
Houston, Texas
San Antonio, Texas
None of the above
West Region: Which Nuvia location are you closest to?
*
Fullerton, California
San Diego, California
Denver, Colorado
Las Vegas, Nevada
Salt Lake City, Utah
Bellevue, Washington
None of the above
What Is Your First Name?
*
What Is Your Last Name?
*
What Is Your Best Email?
*
What Is Your Best Phone Number?
*