ACCESSIBILITY
Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our Pinole Shores Dental office by phone @ 510-724-5100 or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

Office Hours
Monday:   Closed
Tuesday:   8:15 AM - 4:00 PM
Wednesday:  8:15 AM - 4:00 PM
Thursday:   9:00 AM - 5:00 PM
Friday:   8:15 AM - 1:00 PM
Saturday:   8:15 AM - 3:00 PM (every other Saturday)

Please do not use this form to cancel or change an existing appointment.


Items in bold are required.
Name:  
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
Preferred day(s) of the week for an appointment?
Preferred time(s) for an appointment?
Please describe the nature of your appointment (e.g., consultation, check-up, etc.):
 
 

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.  Please note that we do not respond to you via e-mail.  One of our friendly staff will be contacting you on the phone to set up your appointments.