Make a Payment Online

Secure and Convenient

Pay Your Orthodontic Bill Online

As a technology-embracing orthodontic practice, we always look for new ways to make your orthodontic experience as easy and convenient as possible. Our online payment portal makes it easy to pay your bill – either in full or in part – securely online.

To use our payment portal:

Refer to your monthly statement for current balance and total due
Fill in the requested information below. Please note that all fields are required.
To make a payment for multiple patients, click the + button and enter their name and payment amount.
Click the 'Next' button
Enter your credit card information
Click the 'Pay Now' button

Payment Form

"*" indicates required fields

Step 1 of 2

Payor Information

First Name*

Last Name*

Email Address*

Phone Number*

Patient Information

Patient First and Last Name*

Payment Amount*

Add / Remove Patient

Add

Patient First and Last Name

Payment Amount

Add / Remove Patient 2

Add

Patient First and Last Name

Payment Amount

Add / Remove Patient 3

Add

Patient First and Last Name

Payment Amount

Add / Remove Patient 4

Add

Patient First and Last Name

Payment Amount

Total

Payment Information

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Comments

This field is for validation purposes and should be left unchanged.

See For Yourself Just How Amazing an Orthodontic Experience Can Be

Your journey to a healthy, more beautiful smile begins with a simple click. Schedule your complimentary new patient consultation today. We offer virtual and in-office options for your convenience.

Orthodontist · Lander & Riverton, WY

Make a Payment Online

Secure and Convenient

Pay Your Orthodontic Bill Online

Payment Form

Payor Information

Patient Information

Payment Information

See For Yourself Just How Amazing an Orthodontic Experience Can Be

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