Call:805-928-6776
Appointment Request

NEW PATIENTS RECEIVE A FREE TAKE HOME TEETH WHITENING KIT WITH THEIR FIRST VISIT.

REQUEST AN APPOINTMENT TODAY! 

*Image may not be representative of the actual kit

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

Attention new patients: Prior to your first visit, please complete patient forms for the office you are visiting by clicking the "New Patient Forms" link next to the office address below. (Available in SLO, coming soon to Santa Maria and King City.)

Santa Maria: 805-928-67761670 S. Broadway

San Luis Obispo: 805-543-8440 - 1338 Santa Rosa St.   >>> New Patient Forms SLO

King City: 831-386-0958550 Canal St. Suite A

Our office hours are Monday thru Thursday 9:00am to 5:00pm, Fridays 8:00am to 4:00pm

 

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


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
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Which office location(s) would you prefer for your appointment?

Preferred day(s) of the week for an appointment?
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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.