(262) 377-0852

1200 Seventeenth Avenue
Grafton, WI 53024

Financial Information

Financial Information And Guidelines

Financial Guidelines

We are committed to providing you with the best care possible to achieve total oral health. In order to achieve these goals, we need your assistance and your understanding of our financial guidelines

We accept all major dental insurance payments, however we may not be an in network provider for your plan. If we are not an in network provider, review your plan details, as in many cases insurance reimbursement is very similar.

We are in Network for: 

  • Delta Dental Premier

  • Assurant/ Sunlife

  • United Healthcare

  • Lincoln Financial

  • Scion Dental

  • Cigna

  • Insurance Plans in the DHA network – This includes SOME BUT NOT ALL United Concordia plans and Aetna PPO plans.

  • Anthem 300 Plan

Please understand, that we do our best to keep our patients updated with their insurance coverage but NO ESTIMATE IS A GUARANTEE OF PAYMENT. Patients are responsible for all charges not paid by your insurance.


  • Patient portion or patient co-pay is due at the time services are rendered – unless prior financial arrangements have been made.
  • Minors must be accompanied by a parent or legal guardian. If the parents are separated or divorced, the person accompanying the minor will be responsible for co-payment at the time of service.
  • Payment Information:
    • All major credit cards are accepted (Visa, MasterCard, Discover, Amex)
    • 10% Discount for our uninsured cash/check/debit paying patients
    • Financing options with CareCredit®

Short Cancelled/ Missed Appointments

  • Unless an emergency occurs, we expect to run on time for your appointments, and we appreciate the same courtesy from you. Please give 48 hours notice if you are unable to keep your reserved time. Any combination of two missed or short cancelled appointments in a 12 month period may result in either a $1/min charge or dismissal from our practice.

Office Hours

Office Location

Kurt R. Kwiatkowski, D.D.S. S.C.

1200 Seventeenth Avenue
Grafton, WI 53024
(262) 377-0852