Appointment Request

We know you have many choices when choosing a dentist so we greatly appreciate the trust you place in Advanced Dentistry. For your convenience, you may request an appointment on our website or simply call 702-399-9118 to schedule a time that works for you.

**Please do not use this form to cancel or change an existing appointment.


Items in bold are required.
Name:
Address:
City:
State/Province:
Zip/Postal:
Phone:
Email:
Are you a current patient?
Best time(s) to call?
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.