Appointment Request

pasadena dentist dr. koutcheckThe first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our office manager will contact you to confirm your appointment.

Please do not use this form to cancel or change an existing appointment.

 

 

 

 

Office Hours: 

Pasadena Smiles (Pasadena):
Mon: 9:00am - 6:00pm 
Tues: 9:00am - 6:00pm 
Wed: 9:00am - 6:00pm 
Thurs: 9:00am - 6:00pm 
Fri: 9:00am - 6:00pm 
Sat: 8:00am - 3:00pm 

Mission Dental (South Pasadena)
Mon: 9:00am - 6:00pm 
Tues: 9:00am - 6:00pm 
Wed: 9:00am - 6:00pm 
Thurs: 9:00am - 6:00pm 
Fri: 9:00am - 6:00pm 
Sat: 8:00am - 3:00pm 

New! Save time at the office by downloading our New Patient form. Print and fill it out at home and bring it in for your first appointment!

*Items in bold are required.
Are you a current patient?


Which office location(s) would you prefer for your appointment?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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Pasadena Smiles
900 Valley View Ave, Suites 2 & 3
Pasadena, California 91107
(626) 510-6633

Mission Dental
1401 Mission Street, Unit C4
South Pasadena, California 91030
(626) 399-0204
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