FIRST AMENDMENT TO SERVICES AND SUPPORT AGREEMENT

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                                                                  EXHIBIT 10.19

                               FIRST AMENDMENT TO
                         SERVICES AND SUPPORT AGREEMENT

         This First Amendment to Services and Support Agreement (the "First
Amendment") effective as of February 1, 1999, is by and between Coast Dental
Services, Inc., a Delaware corporation ("CDS") and Coast Dental Southeast,
P.A., a Georgia professional association (the "Dental Practice Entity").

                                R E C I T A L S

         WHEREAS, CDS and Dental Practice Entity are parties to that certain
Services and Support Agreement dated as of September 29, 1997 (the "Services
and Support Agreement"); and

         WHEREAS, CDS and the Dental Practice Entity are now desirous of
modifying the Services and Support Agreement in accordance with the terms of
the First Amendment.

         NOW, THEREFORE, for good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged by the parties, the parties agree
to modify, supplement and amend the Services and Support Agreement as follows:

         1. Recitals. The statements contained in the Recitals of facts set
forth above are true and correct and are by this reference made a part of the
First Amendment.

         2. Service and Support Fee. Exhibit "A" to the Services and Support
Agreement is hereby amended to change the S&S Fee percentage to Seventy-three
percent (73%).

         3. Deletion of Section 3.4. The Services and Support Agreement is
hereby modified to delete Section 3.4 related to the payments to the Dental
Practice Entity for added internally developed Dental Centers.

         4. Other Provisions. All of the terms and provisions contained in the
Services and Support Agreement shall remain in full force and effect unless
specifically modified, supplemented or amended by the First Amendment.

         IN WITNESS WHEREOF, the parties have hereunto set their hands and
seals on the day and year first above written.

                                         "DENTAL PRACTICE ENTITY"

                                         COAST DENTAL SOUTHEAST, P.A.

                                         By: /s/ Xxxx Xxxxxx
                                            ----------------------------------
                                                 Xxxx Xxxxxx, President
                                         "CDS"

                                         COAST DENTAL SERVICES, INC.



                                         By: /s/ Xxxxx Xxxxxx
                                            ----------------------------------
                                                 Xxxxx Xxxxxx, 
                                                 Chief Executive Officer