Appointment Request

We are going to make you smile!

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, call/text our Mesa office Phone Number or Queen Creek office Phone Number directly.

Please note these forms are 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.

Request an Appointment at our Mesa Location:

• For existing periodontial patients wanting to scheduled your next cleaning? (opens secure external forms portal in a new window)  
• Schedule an exam with a Periodontist for any periodontial or bone loss concerns (opens secure external forms portal in a new window)  
• Schedule an exam with a Periodontist for any other concerns. (implants, recession/tissue grafting, biopsy, etc.) (opens secure external forms portal in a new window)  

Request an Appointment at our Queen Creek Location:

Online requests coming soon. Please contact the office at (480)988-6609.