Appointment Request

The first step towards a beautiful and healthy smile is to schedule an appointment.  Feel free to complete the form below and our patient care coordinator will contact you to confirm your appointment.  For an immediate response, please contact our office by phone (925) 973-0200.  For your convenience, we are open Tuesday, Friday, and Saturdays from 8am to 5pm and Wednesdays 9am to 6pm.  We accept most major insurances.

Appointments are scheduled exclusively for you and a 48-hour notice is required if you are unable to keep a scheduled appointment.  Otherwise, a fee will be assessed to the account for time reserved.  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.