accessibility ACCESSIBILITY
Call: (209) 477-0222

Appointment Request

The first step towards healthy, beautiful teeth 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.

FRIDAY AND SATURDAY APPOINTMENTS MADE BY SPECIAL ARRANGEMENT

*Items in bold are required.


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.):

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

Testimonials

View More