Call Us at (248) 879-2980

Welcome New Patients!

Insurance Information

For your convenience, we accept most major PPO insurance plans. We also accept cash, check and all major credit cards. Please ask us for more details. Kacy Family Dentistry does not participate with Medicaid.

          Delta Dental PPO     Delta Dental Premier         Blue Cross Blue Sheilds          Guardian          DentaMax                            

            United Healthcare          Principal     Cigna          Metlife          Assurant          ADN          Proirity Health  

                Lincoln          NGS CoreSource          AARP     Always Care          Aetna       Humana          ABS  

                                    FepBlue Dental     UMR             KDF Smile Discount Plan    


If you are more than 15 minutes late for your appointment, we will have to reschedule, and you will be charged a fee. If the appointment is not cancelled within 24 hours then there will be a charge of $50.00 for 2 hour appointments. For hygiene and one hour appointments such as fillings, post and cores, extractions, and crown cements there will be a $25.00 charge.     

New Patient Information Forms:

Please make sure to click on each link below, (5) per Adult & Child and completely fill out all information provided...

Please click on the links below:

Adult Patient (14 & Older) Information Form:     Child (13 & Under) Information Form:  

Adult Health History pg. 1                              Child Health History pg. 1                  

Adult Health History pg. 2                               Child Health History pg. 2                                           

HIPPA Compliance Form:                               Office Policy: