Patient Registration Forms

Online Oral Surgery Patient Registration Forms

To begin the registration process, please select your preferred office location, complete the secure online form, and upload any relevant x-rays where indicated. Your information will be reviewed promptly, and our team will follow up with next steps. We’ve built this process around security, speed, and simplicity, so your patient’s privacy stays protected while we handle the details efficiently.

South Holland Office

North Holland Office

Grandville Office

Grand Haven Office

Meet Dr. Keith Nalley

Dr. Nalley moved to Grand Haven, MI at 9 years of age after his father was stationed here by the U.S. Coast Guard. This has been his hometown ever since. He graduated from Grand Haven High School.  His undergraduate studies were completed at Hope College in Holland, MI. He received his dental training at the University of Michigan where he received the Chalmers J Lyons Award which is given to the top oral surgery student of the graduating dental class.

He then completed his residency in Oral and Maxillofacial Surgery at The Detroit Medical Center (DMC) / Wayne State Medical School.  In addition to his time spent treating patients, Dr. Nalley has also been very involved in various surgical organizations and committees.

He is a member of the Michigan Society of Oral and Maxillofacial Surgeons and was past president of the Great Lakes Society of Oral and Maxillofacial Surgeons.  He is board certified by the American Board of Oral and Maxillofacial Surgeons and The National Dental Board of Anesthesiology. He is also a fellow of the American Association of Oral and Maxillofacial Surgery.

Education

  • College: Hope College
  • Dental School: University of Michigan School of Dentistry
  • Residency: Detroit Receiving Hospital/Wayne State Medical School

Professional Memberships

  • Great Lakes Society of Oral and Maxillofacial Surgeons – Former President
  • Michigan Society of Oral and Maxillofacial Surgeons
  • American Board of Oral and Maxillofacial Surgeons
  • National Dental Board of Anesthesiology
  • American Association of Oral and Maxillofacial Surgery