Our staff will contact you after submitting the form to check for confirmation or provide potential alternatives if a scheduling conflict is present.

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Preferred Date

YYYY

Preferred Meeting Time (ex: 2:00pm)

Appointment reason

i.e. tooth ache; initial visit, check up/cleaning

Preferred method of contact

Phone Call

Text

Monday - Friday

8:00am - 4:00pm

Saturday - Sunday

Closed

1118 S Perry St, Spokane, WA 99202

509-534-2232