+81-3-6280-5460
Contact Us
Appointment
Are you a new patient? ※Required First visitReturn visit
Please choose the kind of appointment you need Implants Whitening Esthetic treatment Cavities Periodontal disease Dental check-up Cleaning Bad breath treatment Gum swelling Brushing instructions
Preferred date(First preference) ※Required
Hope time zone(First preference) ※Required 09:00~10:0010:00~11:0011:00~12:0012:00~13:0014:00~15:0015:00~16:0016:00~17:00
Preferred date(Second preference) ※Required
Hope time zone(Second preference) ※Required 09:00~10:0010:00~11:0011:00~12:0012:00~13:0014:00~15:0015:00~16:0016:00~17:00
Preferred date(Third preference) ※Required
Hope time zone(Third preference) ※Required 09:00~10:0010:00~11:0011:00~12:0012:00~13:0014:00~15:0015:00~16:0016:00~17:00
Name ※Required Mr.Ms.
Phone ※Required
Email address ※Required
Please contact method of hope ※Required TELEmailEither
Please write down any comments or questions
Tel +81-3-6280-5460
PAGE TOP