Request an Appointment


9217 S. Redwood Road, Suite C
West Jordan, UT 84088
(801) 568-0172
(801) 568-3932 fax

To request appointment availability, please fill out the form below. Our scheduling coordinator will contact you to confirm your appointment.


Would you prefer to receive Smile Reminders by Text or E-mail?


Is there a specific date that you would prefer?
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What day of the week would you like to come in?


What time do you prefer?


Full Name


Email Address


Phone Number
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Please describe the nature of your appointment :