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

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Phone: *

Email address: *

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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:

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Victorville Office

12120 Ridgecrest Rd
Suite 203
Victorville, CA 92395

(442) 229-0766

Century City

2080 Century Park E
Ste 1103
Los Angeles, CA 90067

(310) 553-2233
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