7608 Bergenline Ave #1, North Bergen, NJ 07047
Request Appointment
Call Us: (201) 869-1107

Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before? *

Yes No  

What is the reason for the appointment? *

  Initial Consultation
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:


How do you prefer to be contacted? *

  Email   Phone  


It may take a moment to submit your information. Please wait for a confirmation message.


7608 Bergenline Ave #1
North Bergen, NJ 07047-4958

Call Us (201) 869-1107
Office Hours
Mon: 9:00am-1:00pm and 2:00pm-6:00pm
Tues: 2:00pm-6:30pm
Wed: Closed
Thur: 9:00am-1:00pm and 2:00pm-6:00pm
Fri: 9:00am-1:00pm and 2:00pm-6:00pm
Copyright © 2017-2020 Nick Romanides Orthodontics and WEO Media (Touchpoint Communications LLC). All rights reserved.  Sitemap | Links