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Appointment Request

The first step toward achieving a healthy smile for your child is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

Please note this form is for requesting an appointment only. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly at (805) 773-1600.

Contact Information:

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