If you are a new patient, click here to fill out New Patient Information.
Schedule Your First Appointment
Daytime Phone Number:
Evening Phone Number:
First Choice: Preferred Time Of Day: MorningAfternoonNo Preference
Second Choice: Preferred Time Of Day: MorningAfternoonNo Preference
Upon submission of this form, we will contact you soon to verify your appointment day and time, as well as answer any questions you may have. We look forward to providing you with the best service possible!
Please Fill the code below in the text box to continue :
Your Name (required)
Your Email (required)
Day Time Phone Number(required):
Evening Time Phone Number(required):
Dental Questions - Dr. Michael A. Kezian Insurance Questions - Karine Clinical Questions - Ellie
Comments, Questions, Suggestions:
Enter the words below in the text field to continue: