South Shore Dental Excellence
3 Convenient Locations

(813) 413-5424

Quality Care For ...

• Implant Dentistry
• Cosmetic Dentistry
• Invisalign
• Tooth Whitening

South Shore Dental Excellence

Appointments:
(813) 413-5424

Richard Kernagis, DMD
Jennifer Kernagis, DMD

13145 Kings Lake Drive Suite 105
Gibsonton, FL 33534

General Info: (813) 413-5424

Map & Hours

New Patient Forms

Download Our New Patient Forms

For your convenience, our New Patient Forms are available for download here in Adobe Acrobat PDF format. The Adobe Acrobat Reader is FREE and can be downloaded by clicking on the icon below.

Please print and complete these forms at home before your first appointment. If you need assistance with downloading or printing these forms, please contact our office at (813) 413-5424.

• Patient Information & Insurance
• Dental History & About Your Smile
• Medical History Exam
• Notice of Privacy Practices
• Financial Agreement Acknowledgement

Download Free Adobe Acrobat Reader Now