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Kevin L. Shelton, DDS
John W. Gallegos, DDS
Molly E. Stice, DMD

Shiloh (618) 624-7200

Glen Carbon (618) 288-6262

Appointment Request

Cosmetic Dentistry Shiloh and Glen Carbon - Dr. Kevin Shelton

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

Glen Carbon Office Hours:

Monday      8:00am-5:00pm
Tuesday      9:00am-6:00pm
Wednesday  9:00am-6:00pm
Thursday     8:00am-5:00pm
Friday         8:00am-2:00pm

Shiloh Office Hours:

Monday       8:00am-6:00pm
Tuesday      8:00am-6:00pm
Wednesday 8:00am-6:00pm
Thursday    8:00am-6:00pm
Friday        8:00am-2:00pm
Saturday    8:30am-2:00pm
*Items in bold are required.
Are you a current patient?


Which office location(s) would you prefer for your appointment?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Shiloh Office Hours:

Monday 8:00am-6:00pm
Tuesday 8:00am-6:00pm
Wednesday 8:00am-6:00pm
Thursday 8:00am-6:00pm
Friday 8:00am-2:00pm
Saturday 8:30am-2:00pm

309 Tamarack Lane,
Shiloh, IL 62269
Ph (618) 624-7200

Glen Carbon Office Hours:

Monday 9:00am-6:00pm
Tuesday 9:00am-6:00pm
Wednesday 9:00am-6:00pm
Thursday 8:00am-5:00pm
Friday 8:00am-2:00pm

2246 S. State Rt. 157, Suite 125
Glen Carbon, IL 62034
Ph (618) 288-6262

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