Secure Bill Pay
Mohawk Dental is pleased to offer our patients the ability to pay their bill online with SSL security and 128-bit encryption. Your bank account's information is only used to process your payment and is never stored online or in our office. There are no additional fees — we offer this service as a courtesy to our patients.
Your Information
Name on Statement:
Your Name:
Your Email Address:
Your Phone Number:
Billing Address:
 
City:
State:
Zip Code:
Country:
 
Bank Information
Name on Account:
Account Type:
Checking or Savings:
Bank Account #:
Bank Routing #:
 
Amount:
$ USD
Comments:
 
Please click on the Pay button once. Clicking multiple times may result in multiple transactions. Please do not close the browser or refresh this page until you receive a confirmation page. If you think there was a transaction error, please contact our office. By clicking the Pay button you approve Mohawk Dental to withdraw the amount you entered from the account information you provided.