Do you want WildSmiles Braces? You’re not alone!

We will call your orthodontist and tell them that you want WildSmiles! Just follow the simple steps below:

• Completely fill out the information below
• List your Doctors name and Phone Number in the “Comments” box
• Click “Submit”

We will contact your orthodontist and they can have the braces by your next appointment!

Don’t forget to print off the “Braces Request Page” and take it to your doctor’s office!

Kids and Parents we want to hear from you! Please use the contact page to share fun stories with us about your experience with WildSmiles or ask us any questions you may have about the braces.

We look forward to hearing from you and will respond shortly.