comfortdentalglencove.com
Family dentist at 36 Glen Street in Glen Cove, NY: implant restorations, whitening, orthodontics, pediatric and emergency care. Call or text (516) 676-1300.
First seen 2026-11-09 · Last seen 2026-11-09 · Source: webmcp.com
Answer 4 · Act 3 · Transact 0 · Score: Not yet scored
Tool inspector
appointment_request_form
Fill in the Comfort Dental at Glen Cove appointment request form for any visit type (implants, whitening, crowns, root canals, orthodontics, dentures, pediatric, gum treatment, extractions, emergencies, and more). This creates an appointment REQUEST, not a guaranteed booking; the office will confirm with the patient, usually within one business day. Do not submit on the patient's behalf: after filling, the patient must review the form and click "Send Message" themselves. Never enter medical history, date of birth, insurance member/ID numbers, or payment information. Routine cleanings and exams can instead be self-booked at https://dental4.me/comfortdentalglencove/1. For emergencies, call or text (516) 676-1300.
Page: /
Input schema
| Property | Type | Required | Description |
|---|---|---|---|
form-name |
string | no | — |
subject |
string | no | — |
language |
string | no | — |
bot-field |
string | no | — |
firstName |
string | no | Jane |
lastName |
string | no | Smith |
phone |
string | no | (516) 555-1234 |
email |
string | no | jane@email.com |
patientType |
string | no | — |
service |
string | no | — |
insuranceProv |
string | no | Delta Dental, Aetna, HealthFirst, etc. |
message |
string | no | Anything that would help us prepare... |
preferredWindow |
string | no | — |
Raw JSON schema
{
"type": "object",
"properties": {
"form-name": {
"type": "string"
},
"subject": {
"type": "string"
},
"language": {
"type": "string"
},
"bot-field": {
"type": "string"
},
"firstName": {
"type": "string",
"description": "Jane"
},
"lastName": {
"type": "string",
"description": "Smith"
},
"phone": {
"type": "string",
"description": "(516) 555-1234"
},
"email": {
"type": "string",
"description": "jane@email.com"
},
"patientType": {
"type": "string",
"enum": [
"New Patient",
"Existing Patient"
]
},
"service": {
"type": "string",
"enum": [
"New Patient Exam & Cleaning",
"Dental Implants",
"Cosmetic Dentistry / Whitening",
"Crowns & Bridges",
"Root Canal",
"Orthodontics / Braces",
"Pediatric / Children's Dentistry",
"Dentures & Partials",
"Periodontal / Gum Treatment",
"Tooth Extraction",
"Emergency / Tooth Pain",
"Other"
]
},
"insuranceProv": {
"type": "string",
"description": "Delta Dental, Aetna, HealthFirst, etc."
},
"message": {
"type": "string",
"description": "Anything that would help us prepare..."
},
"preferredWindow": {
"type": "string"
}
}
}
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