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Dental History Form

Click on the link below to download and fill out the Dental History Form. The file is in PDF format.
Dental History Form (PDF)

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Office of Dr. Timothy Wahl

We are a private practice specializing in the diagnosis and treatment of disorders and diseases of the gum tissues and supporting structures of the teeth.

While we offer comprehensive periodontal care, we place special emphasis on regeneration of gum and bone tissue and on esthetic/cosmetic smile enhancement.

We will provide our patients with the highest quality of personalized care, using state of the art technology, in a cheerful, relaxed environment.

Timothy M. Wahl, D.M.D.
Diplomate American Board of Periodontology
Practice Limited to Periodontics
190 South Sykes Creek Parkway, Suite 2
Merritt Island, FL 32952
P: 321.459.0154
F: 321.459.0739

Office Hours:
Monday, Tuesday & Thursday 8:30 am - 5 pm
Wednesday 9 am - 1 pm
Friday 8:30 am - Noon

Please Contact Us to set up an appointment.