214-522-4330

Name:

Phone:

Email:

Comments:




 

Dallas Dentists - Request a Dental Appointment

For your convenience, we will try to arrange your office visits for times that fit your schedule.  For routine dental services, cleanings, or to set a time for a consultation for reconstructive or cosmetic dentistry, please use this form to request an appointment.

To request an appointment, please fill out the form below and send it to us by clicking the "Send" button. We will follow up with you to confirm an appointment time.

* Required

   
*Your Name:
*Your E-mail Address:
Please note the reason for your appointment:
Be as specific or general as you like, (i.e. --"I need a cleaning" or "I would like to discuss options for fixing my teeth", etc.).

Office Hours

Appointments are available Monday through Thursday: 7:00 a.m. - 4:00 p.m. The office is closed Friday, Saturday and Sunday.

Emergency service is available.

What time, (or range of time), is convenient for you?
Be as specific or general as you like (i.e. --"Monday 12/29/2001 at 11:15 pm" or "Any Tuesday or Thursday before 2:30 pm", etc.).
Are you a new patient?
Please provide phone number(s) where our office may reach you.
*Home Phone:
Work Phone:
If you don't mind, please tell us how you heard about our office.
Use area below for referrals or other


We check our e-mail daily and will usually reply
in 24 hours or less.