Prestonwood Dental Online Appointment Form

Please use this form to request a new dental appointment with Dr. Daftary at Prestonwood Dental. Please do not use this form to re-schedule existing appointments. If you need to arrange a different time or day, call our office at 972-239-1998


* Before we see you, briefly explain your needs:

* Select preferred day(s) for your appointment:
 Monday Tuesday Wednesday Thrusday Friday

* Select the time of day you prefer:
 Anytime Morning Afternoon

Please provide your contact information: *required fields

* Your name:

* Phone Number:

* Email Address:

* Best time to call you:

* How did you hear about us? OR Whom shall we THANK for YOUR referral?

* Word Verification:

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Please enter the word above to submit.

 
Request your appointment

Appointment requests are answered promptly; usually in less than 24 hours. Sending this form is simply a request for a dental appointment. You are under no financial obligation. Our office observes HIPAA Federal regulations that protect your privacy.