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.

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

Items in bold are required.

Are you a current patient?
Yes No
Best time(s) to call?
Morning Noon Afternoon Evening
Which office location(s) would you prefer for your appointment?
Anaheim 2300 S. Harbor Blvd
Cypress 11741 Valley View St., Ste E
Orange 1502 E. Collins Ave.
Riverside 3845 Pierce St., Suite A
Anaheim Hills 140 S. Fairmont Blvd.
Brea 2820 E Imperial Hwy
Preferred day(s) of the week for an appointment?
Any Day Monday Tuesday Wednesday Thursday Friday
Preferred time(s) for an appointment?
Any Time Morning Noon Afternoon Evening
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.

** FREE Teeth Whitening Kit w/any procedure for those who qualify.