Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment. 


Please do not use this form to cancel or change an existing appointment.

Office Hours
Monday 8:00AM - 5:45PM
Tuesday  7:15AM - 4:00PM
Wednesday 8:00AM - 5:45PM 
Thursday 7:15AM - 4:00PM 
Friday   7:15AM - 4:00PM
Saturday  8:00AM - 12:00PM (First three Saturdays of the month)



 

 

 
 


Items in bold are required.
Name:
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.