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Appointment Request 

The first step towards a beautiful, healthy smile is to schedule an appointment with us at Parker Family Dental. Whether you need a dental implant or an appointment for your teeth to be cleaned, we are here to help.  We serve all the locations around Parker, Arizona.  These include Quartzsite, Bouse, Salome, Needles, Blythe, Big River, and Lake Havasu City.  Please contact our office by phone @ 669-2573 or complete the appointment request form below. Our scheduling coordinator will contact you to set up an appointment.  Thank you very much for giving us the opportunity to provide for your dental needs.

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

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

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

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


We combine experience with the latest in dental technology to deliver the best patient experience possible.