Richmond Dental Clinic
Creating Beautiful Smiles
We Accept All Insurances

Appointment Request

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

Please do not use this form to cancel or change an existing appointment.
*Items in bold are required.
Are you a current patient?


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.

Testimonials

Ms. Shahla at the reception is the best and Dr. Pezeshki and his team are so expert. Thank you.

mojgan ahmadi

This is a good place the staff were kindly

Nazila Karimi

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