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Make an Appointment

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Please fill out the form below to request a time for your appointment.

If you have any questions or comments, please feel free to contact us by phone or via email. We are always happy to hear from you!

Patients Name: *
Parent Name:
Address: *
Phone: *
Email: *
Best time to contact you: *
Requested Appointment Time & Date:
(1st choice)
Requested Appointment Time & Date:
(2nd choice)
Additional Patients:
Your Comments:
* Indicates Required Field.

Children`s Dental Group
8430 W Lake Mead Blvd
Suite 150
Las Vegas, NV 89128
Tel 1-702-220-9100