Request an Appointment

The first step towards a beautiful, healthy smile is to schedule an appointment. Please call or text our office at (909)989-4709 to request an appointment or complete the appointment request form below. Our scheduling coordinator will contact you as soon as possible to reserve your appointment.

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.

ADA
Tri-County Dental Society
CDA