LA Smiles Dentistry

We would love to have the opportunity to give the great service you love to your friends and family! Ask about our Referral Program.

L.A. Smiles Dentistry
5010 S. La Brea Avenue
Los Angeles, California 90056

Phone: (323) 686-6522
Fax: (323) 290-4072
emailus@lasmilesdentistry.com

Monday	9 - 6
Tuesday	9 - 6
Wednesday	9 - 6
Thursday	9 - 6
Friday	9 - 5
Saturday	9 - 2

To schedule your private consultation with our exceptional dentist, Dr. Rahimi, please complete the form below, and a member of our staff will contact you soon.

Please do not use this form to cancel or change an existing appointment. *Items in bold are required.

Name:
Address:
City:
State:
Zip:
Email:
Phone:
Best Time to Call?
Morning Noon Afternoon Evening
Preferred day(s) of the week for any appointment?
Any Day Mon Tues Wed Thurs
Preferred time(s) for an appointment?
Any Time Morning Afternoon
What are you primarily interested in?
Cosmetic Dentistry General Dentistry Implants Whitening Crowns
Please describe the nature of your appointment (consultation, check-up, etc.)


How did you hear about LA Smiles?
Postcard Internet Family/Friend Referral Dr. Rahimi and Staff Other

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Content on this page requires a newer version of Adobe Flash Player.