accessibility ACCESSIBILITY

 
The first step towards a beautiful, healthy smile is
to schedule an appointment!
 

 

 

Please contact our practice by phone at (623) 536-6789, or complete the Appointment Request form below.

  Our Scheduling Coordinator will contact you to confirm your appointment.

 

Note: this web-page cannot be used to change an existing appointment.




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.