Patient Forms

Please download and fill-out our Patient Registration Form. After you have completed the form, please make sure to bring it on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration Form

Related Links

HOWARD DEFAII, BA, DDS

FAMILY & COSMETIC DENTISTRY

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San Jose Smile Center - Dr Howard Defaii

Office Hours

MON - THU 8:00 am - 4:30 pm

FRI - SUN Closed

Location

827 Blossom Hill Rd suite e-3,

San Jose, CA

Phone : (408) 227-5012
Text Us : (408) 227-5012

Email : sanjosesmile@gmail.com