Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone (209) 723-5405 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours:
Monday - Thursday 8:00 AM - 5:00PM
Friday 8:00 AM - 12:00 PM 

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


Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.