Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before? *

Yes No  

What is the reason for the appointment? *

  Regular Exam / Cleaning
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:

Confirmation

How do you prefer to be contacted? *

  Email   Phone  

 
 

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Office Location

5712 E Lake Sammamish Pkwy SE
#108
, Issaquah, WA 98029
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Opening Hours

Mon–Thurs: 7am–6pm
Friday: By Appointment
Saturday: 2nd Sat each month
Sunday: CLOSED
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Phone

(425) 270-1075

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