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Appointment Request

Santa Clara Location
3700 Thomas Road. Suite 203
Santa Clara , CA 95054
Phone: (408) 235-7600

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 scheduling coordinator will contact you to confirm your appointment.

You are scheduling an appointment for our 3700 Thomas Rd. Ste. 203 Santa Clara, CA 95054 location.

For our San Jose site, please click here

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

Items in bold are required.
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.