Minneapolis Dentist | Appointment Request

West Lake Dental Center

Dr. Erickson & Dr. Langley

Family, General and Cosmetic Dentistry

(612) 926-9000

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Call: (612) 926-9000

(612) 926-9000

Appointment Request

It would be our pleasure to serve you! Please contact our dental office either by phone or by completing the appointment request form below. Stephanie, our scheduling coordinator, will be in contact with you shortly to confirm your appointment.

Please do not use this form to cancel or change an existing appointment. We kindly request that you call us by phone to make schedule changes.

*Items in bold are required.

Name: Email: Phone:

Are you a current patient? Yes
No

How did you hear about us?

Which office location(s) would you prefer for your appointment?

Minneapolis 3033 Excelsior Blvd.

Preferred day(s) of the week for an appointment?

Any DayMondayTuesdayWednesdayThursdayFriday

Preferred time(s) for an appointment?

Any TimeMorningNoonAfternoonEvening

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

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

Testimonials

We at West Lake Dental Center sincerely appreciate the opportunity to serve you and your family's dental needs. Our dedication to educating and serving the greater Twin Cities area is unwavering. We pride ourselves on that extra level of communication and service that is so important to patients.

West Lake Dental Center

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