If you have been referred to our expert dentist, Dr. Anne Nicholas, by a family member, friend, or another dentist or doctor, we invite you to fill out the referral form below. Our friendly dental team will contact you and schedule your appointment at our comfortable dental office in Palm Desert, California. To learn more about us and how we can improve your smile, we welcome you to call us today. We are eager to care for you!

Referral Form


Contact Information
First Name *
Last Name *
Email *
Phone 1 *
Date *
Referred By *