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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 appointment coordinator will contact you to confirm your appointment during our normal business hours (Mon - Thu 9 am - 7 pm).   If you need urgent care, please call (408) 591-8217 for emergency after office hours.
Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.

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Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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