Fremont-CA-dentist.com

Contact Information

We are not requesting any confidential information in this form. If you have dental insurance, our office manager will be calling you to get additional information to verify your specific benefits.

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Insurance Carrier	:

Appointment Request Information

Type of Appointment

New Patient Exam

Return/Recare Visit (Existing Patients)

Dental Implants Consultation Visit

Dental Veneers (Lumineers) Consultation Visit

Invisalign Consultation Visit

Call me in the event of a cancellation for an earlier appt.

Time of Day

Am (morning)

Pm (evening)

Other Specific Requests

Appointment Date

We will process your appointment request as quickly as possible. You will receive a follow-up e-mail and phone call to confirm your appointment.

We will try to schedule your appointment request as close as possible to the time of day and date requested. Please fill out any details that will be helpful in scheduling your appointment such as only available on Tuesday mornings in the Further Details form field.

For appointments regarding complicated issues, emergencies, or requiring scheduling as soon as possible - call our office - (510)-795-7786, and ask to speak with Alka or Amy

Note: We are close to I 880 and centrally located in Fremont CA; easily accessible to all surrounding cities including Hayward, Newark, Union City, San Leandro, Oakland and San Jose

We offer CareCredit if required by patients to cover dental expenses.

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