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Please don't include personal medical details — specific care is discussed during your visit.

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Patient Information

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Appointment InformationPreferred Appointment Date

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Children in pre-school and elementary grades are usually seen in the morning; late afternoons are reserved for older students.

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Exam, Cleaning & X-Ray Toothache or Other Emergency Recommended Treatment Other

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Please use this form for general information only. Do not send personal health information. Availability varies by request. Your appointment will be confirmed by phone.

1235 W Vista Way Ste. F Vista CA, 92083(760) 330-5595Mon - Fri 8:00AM-5:00PM