Dr. Michael Shannon’s Free Cosmetic Dentist Smile Analysis in the Kennewick WA area.

If you are 18 years old or older, we would be pleased to provide you with a free smile analysis.

Please provide us with the following information and a member of our staff will contact you soon to schedule an appointment.

Smile Analysis Questionnaire

*First name:

*Last name:

*Phone:

*Email:

*ZIP/Postal Code:

How many teeth show in your smile?

Are you happy with your smile?

Yes No

Describe the color of your teeth:

Are your teeth evenly colored?

Yes No

Are there any defects on your front teeth?

Yes No

Any fillings or crowns showing?

Yes No

Are your teeth crowded?

Yes No

Do you have spaces or gaps between your teeth?

Yes No

How many?

Do your gums show when you smile?

Yes No

Do you like the amount of gums that show when you smile?

Yes No

Further comments about your smile:

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Call for an appointment:
(509) 783-0824

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Shannon Dental Health Center

Michael E. Shannon, D.M.D.

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Shannon Dental Health Center

800 North Center Parkway
Kennewick, WA 99336

General Info: (509) 783-0824

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Comfortable, Affordable Care

Smile Analysis Questionnaire

Call for an appointment:(509) 783-0824

Michael E. Shannon, D.M.D.

Call for an appointment:
(509) 783-0824