Your Premier Smile Makeover Provider

Fairfax Medical Center 
10721 Main Street, Suite 2200
(Back Building)
Fairfax, Virginia 22030

New Patient Forms

Dr. Ortega and her staff are dedicated to providing you the best dental care experience possible. For added convenience and to save you time at your next appointment, we ask that you please click here to download and complete our New Patient Form and bring them with you to the appointment.