Request Appointment

To make an appointment, please fill out the following form…

* This form will tell us when you’d like to see us. We will confirm your appointment with our dentists by e-mail or phone.

 Make appointment Change appointment
FIRST NAME:
LAST NAME:
EMAIL:
PHONE:
ADDRESS:
TYPE OF VISIT:
 Cosmetic Consultation Implant Consultation Invisalign Consultation I.V. Sedation Consultation General Dentistry Consultation Teeth Cleaning Zoom Teeth Whitening
PREFERRED TIME:
 Morning Afternoon

REFERRED BY:

COMMENTS:

New Patient?

Before your appointment, please fill out this online new patient registration form to send us your information securely…

If you live outside of Northern California, we can help with your travel plans, hotel and car rental. We will do everything we can to make your stay in the Bay Area easy and comfortable. See our special services for International Patients.

Contact Us

Peninsula Center of Cosmetic Dentistry
99 3rd St
Los Altos, CA 94022

Ph: 650-948-5524
Fax: 650-948-1887
Email: info@pccd.net

Hours:

  • Mon, Tue, Thu: 8am-5pm
  • Wed: 7am-6pm
  • Fri: 7am-5pm

Understanding your Dental Insurance >
Directions to our office >
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