Request an Appointment

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below or give us a call.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly at (425) 523-4179.

Patient Name *

Email

Phone *

Preferred Date *

Preferred Time *

Comments

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