Make An Appointment

To schedule an appointment at Burmeister Family & Cosmetic Dental you may call our office or complete the appointment request form below. We will then contact you within one business day to confirm your appointment.

If this is an emergency, or if you are trying to cancel or change an existing appointment, please do not use this form.

First Name*
Please provide your first name

Last Name*
Please provide your last name

Phone Number*
Please provide your phone number.

Email*

Address*
Please provide your address

City*
Please provide your city

State*
Please provide your state

Zip*
Please provide your zip

Preferred Dates and Times*
Please provide your preferred dates and times.

Preferred Doctor:*

Burmeister

Douleh

Preferred Doctor*:
Burmeister
Douleh

Reason for appointment*
Please tell us why you are contacting us today.