Secure Online Patient Registration Forms

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

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Comprehensive Oral Surgery. Healthy Smiles Start Here. Call us Today!
Los Angeles CA
Los Angeles Phone Number 310-670-0220
Rowland Heights CA
Rowland Heights Phone Number 626-913-5700
Mission Hills CA
Mission Hills Phone Number 818-365-0817
Woodland Hills CA
Woodland Hills Phone Number 818-225-8602

Office Hours: Monday through Friday 8:00am-5:00pm for all locations.