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Make An Appointment

To make an appointment, simply call us at
(202) 638-5400 during business hours:

Monday 8:30 a.m.
-
5:00 p.m.
Tuesday 8:30 a.m.
-
5:00 p.m.
Thursday 8:30 a.m.
-
5:00 p.m.
Friday 8:30 a.m.
-
5:00 p.m.

or fill out the information below and we will contact you shortly to set up a time that's convenient for you!

NOTICE: The following form is not secured by encryption. If you are concerned about sending information through an unsecure channel, please call our office.

*Required fields  
  Name: *
  Daytime Phone: *
  E-mail Address: *
  Will this be your first visit with us?
 

Yes
No

 
  Nature of the appointment:
 

New Patient Exam
Cleaning (Regular checkup)
Cosmetic Dentistry Consult
Other - Explain:

 

Any other comments
or concerns:

   


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About Us | Cosmetic Dentistry | Map/Hours | Conditions | Procedures
Latest Technology | Payment/Insurance | New Patient Forms
Contact Us | Make an Appointment | Ask the Doctor

© Copyright 2003- Dental WebSmith, Inc. and Michael M. Blicher, D.D.S. All rights reserved. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.

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