Serenity Dental

New Patient

Thank you for your interest in our office! Please call us at (360) 844 6344 to schedule a new patient appointment.

If you prefer, you may submit a request to us using the form below and our treatment coordinator will contact you to schedule an appointment.

(*) indicates a required field

Email *

First Name *

Last Name *

Day Time Phone *

Evening Phone

Are you currently experiencing any dental problems?

Yes No

If yes, please describe briefly:

General Dentistry

Cosmetic Dentistry

Periodontal Treatment

Implants

Dentures