Get on the list!

Our practice is slated to open October 2025! Join our RSVP list to be among the first to experience our unique approach to pediatric dentistry where every visit is a celebration.

Patient Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Patient Date of Birth

MM

DD

YYYY

Patient Sex

Nice to Meet You!

How did you find us?

Services of Interest

Email

Phone

(###)

###

####

Comments or special requests

To schedule your child's first appointment, please fill out the following form. Our team will contact you within 48 hours to confirm your preferred date and time. If you have any questions before your visit or need immediate assistance, please call us at (626) 501 -3800.

For existing patients, please use the Patient Portal to schedule a visit or give our office a call at the number above.