Ed Struss Family Dentistry
Root Canals ● Fillings ● Crowns & Bridges Prophy Services (with Registered Hygienist) ● Dentures ● Digital & Panoramic X-rays ● In-Office & Take-Home Whitening Treatments ● Facings, Veneers, & Lumineers®
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153 Burt Rd, Lexington, KY 40503

Caring Dentist Serving Lexington, KY


Patient Registration Form

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If you have dental insurance, Please fill in the following information
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The above information is true to the best of my knowledge. I authorize my insurance benefits be paid directly to the dentist. I understand that I am financially responsible for any balance. I also authorize Ed Struss DMD or my insurance company (if applicable) to release any information required to process my claims. Please type your signature below:
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