Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before? *

Yes No  

What is the reason for the appointment? *

  Regular Exam / Cleaning
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:

 

Confirmation

How do you prefer to be contacted? *

  Email   Phone  

 
 

It may take a moment to submit your information. Please wait for a confirmation message.

 








DOUGHERTY DENTAL
1809 NW DAVIS ST.
PORTLAND, OR 97209

FREE onsite parking
Office Hours
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
8:00AM - 5:00PM
8:00AM - 5:00PM
8:00AM - 5:00PM
8:00AM - 5:00PM
8:00AM - 12:00PM
Closed
Closed
Copyright © 2014-2018 Dougherty Dental and WEO MEDIA. All rights reserved.