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Appointment Request

If you need an appointment we will try to offer you one as soon as possible at a convenient time. You can make an appointment by calling the numbers listed above.

Please Note that the fields marked with [ * ] are mandatory.

Patient's Details

First name *
Last name *
Age *
Sex  Male  Female
Address *
Telephone *
Email address *
Any medical problem?
For eg. Daibetes, Hypertenstion etc
Give brief description about your dental problem *

Preferred date *
Preferred time 10 am 11 am 12 pm 01 pm 02 pm 03 pm 04 pm 05 pm 06 pm
 

Contact Us

Dental Clinic
Uttar Dhoka, Lazimpat
Tel: 4001024,
UTL : 240 7984

Hattisar
Tel: 4413773