Request An Appointment

Fill out the form below to request an appointment with Dr. Baseri at Smile Recreation, and let us know how we can make you smile!

Name

First Name

Last Name

Email Address

Phone Number

(###)

###

####

What's the Reason For Your Visit?

Requested Appointment Date (OPT.)

YYYY

How Else Can We Make You Smile?

By clicking SUBMIT, I agree to receive SMS text messages and emails from Bernard Baseri DDS / Smile Recreation and I confirm that I understand, have read, and agree to the Privacy Policy and Terms & Conditions. By providing my phone number and email, I agree to receive SMS text messages and/or email messages from Bernard Baseri DDS / Smile Recreation.

Our Office:

6221 Wilshire Blvd. Suite #517
Los Angeles, CA 90048