Appointments

To make an appointment with Dr Tariq Drabu and any of his team at Langley Dental Practice, please complete the form below with all of your personal details. Please try and complete as many details as possible. All your details are 100% secure and will not be shared with any third parties.

Your full name: *
Your address: *
Telephone Number: *
Email Address: *
* Required
Which treatments are you interested in? (please select at least one treatment option)
 Teeth Whitening  Treatment under sedation  Dental Implants
 Teeth Straightening  Tooth Coloured Fillings  Veneers/Smile change
 General Dentistry  Minor oral surgery  Botox/Facial fillers
 
 I would like to arrange an appointment
 I would be able to attend at short notice if an appointment becomes available
 
Please give details of the type of treatment that you are interested in and your available appointment times:
 
Where did you hear about us? Math Result *


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