Appointment - Klinik Pergigian Dr Azila - Shah Alam (Official Website)

Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our staff will contact you to confirm your appointment.

Please stated your preferred day(s) , time(s) and describe the nature of your appointment (e.g., consultation, etc)

Online Booking Form

Name*
First Last
Date of Birth*
Phone Number*
Email*
Appointment Date*
Preferred time

: HH

MM
Reason for Visit*
General Dentistry – Dental Checkup / Consultation – Dental Filling / Restoration – Scaling & Polishing – Root Canal Treatment – Dental Extraction – Dentures Cosmetic Dentistry – Composite Bonding – Teeth Whitening – Emax Veneers Orthodontics – Conventional Metal or Ceramic Braces – Damon Braces – Short Term Braces Oral Surgery – Removal of Impacted Wisdom Teeth – Dental Implants – Biopsies Myobrace
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