Samuel F. Jirik, DDS

Cosmetic Dentistry Little Rock AR | Dental Implants Little Rock AR |

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Call today501-843-9561
  • Home
  • About Us
    • Our Difference
    • Meet Dr. Jirik
    • Media
  • Services
    • Implant Dentistry
      • All-on-Four
      • Dental Implants
      • Endosseous and Subperiosteal Implants
    • Cosmetic Dentistry
      • Accelerated Tooth Whitening
      • All-on-Four
      • Cosmetic Crowns
      • Cosmetic Gum Contouring or Grafting
      • Cosmetic Tooth Recontouring
      • Dental Implants
      • Endosseous and Subperiosteal Implants
      • Porcelain Veneers
    • All-on-Four
    • Teeth in an Hour
    • Sedation Dentistry
    • Technology
  • Success Stories
    • Patient Videos
    • Photo Gallery
    • The Winner Is…
    • Testimonials
  • Thoughts
  • Patient Info
    • Frequently Asked Questions
    • Out of Town Services
  • Contact Us

Patient Info

Patient Forms

Click on the links below to open our new patient forms. You can also right click and “Save As” to download them to your computer.

Patient Registration Form (PDF)

Medical History Form (PDF)

HIPPA Notice (PDF)


Financing Options

We accept cash, credit, and financing from the following:
dental-financing-lending-club-Cabot-AR

carecredit

Request an Appointment

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Our Hours

  • Monday 8am - 5pm
  • Tuesday 8am - 5pm
  • Wednesday 8am - 5pm
  • Thursday 8am - 5pm
  • Friday 8am - 2pm
  • Saturday- Closed
  • Sunday - Closed
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Location

Samuel F. Jirik, DDS
606 W Main St
Cabot, AR 72023
Phone: 501-843-9561
Samuel F. Jirik, DDS, PA


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Recent Posts

  • Learn More About Cosmetic Dental Crowns
  • Are Porcelain Veneers Right for You?
  • What Are All-On-4 Dental Implants?
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