Appointment Request

Making an appointment with your Phoenix dentist is now easier than ever! Below, we’ve provided our patients with an online form that they can fill out while having the ability to choose the best date and time for their schedule. Once we receive your appointment request, we’ll contact you as soon as possible in order to further discuss your pending appointment with CenterCare Dental Group. Please feel free to contact our office if you have any questions by calling (602) 252-2800.

Patient Information (* denotes fields that are required)
Patient Name*
Phone Number*
Email Address
Are you a current patient?
No Yes
Best time(s) to call?
Morning Noon Afternoon Evening
Appointment Information
Preferred Appt Date
Preferred Appt Time
Message
Describe the nature of your appointment or any other comments