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Request An Appointment

To Request An Appointment, fill out the form below or call 253-539-7445 or 360-377-0559

Select a clinic to vist:

ParklandSouth TacomaGig HarborBremerton

Patient Name:

Current Patient?YesNoDon't Know

Parent/Guardian Name:

Reason for visit:Checkup/ExamTreatmentEmergency

Preferred day of the week:MondayTuesdayWednesdayThursdayFridaySaturday

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Comments or additional info?

By filling out this form, LDCC has permission to contact you via email, phone, and /or text to set up dental appointment. Please note: once you click send, your appointment has been received by our LDCC staff, even if the spinning icon appears and page does not redirect.

Contact us at: 253-539-7445 OR 360-377-0559

Parkland
Bremerton

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