Novi Orthodontist         Lokar Orthodontics         Novi Braces

Dr. Robert R Lokar

42450 West Twelve Mile Road Suite 220 = Novi MI = 48377 = (248) 348-9540
 


 

For New Patients of Dr. Lokar

Just complete the following form and one of our team members will contact you as soon as possible to schedule a convenient time for your first appointment.

Please provide the following contact information:

Parent's Title
Parent's First Name  
Parent's Last Name
Child's First Name  
Child's Last Name  
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
Call Me At
Best Time Is
How did you hear
about us?
 
Fax  
E-mail
Referred By
(Mrs. Jones)

 
 
We respect your email privacy.  We promise to never sell, barter or rent your email address to any unauthorized third party.

 

 

Call (248) 348-9540 Now To Make An Appointment


Orthodontist
In Novi Michigan and the surrounding
Northville - Walled Lake - Wixom - Farmington Hills MI areas.