If you have an urgent dental need, please do not use the form below to contact us. Call us directly for any dental issues needing to be addressed immediately at 435.604.0887 extension 199.
Your Name (required)
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Treatment request (required)
6-month Check-UpInitial ExamCosmetic ConsultationGeneral Inquiry
Time preference (required)
08:00 – 11:00 AM11:00 – 2:00 PM02:00 – 04:00 PMGeneral Inquiry
Note: Please do not include personal medical information in this form.