Online Forms

Please fill out these two forms prior to coming to our office. Thank you.

  

Patient Information

Medical History

 

These are the documents that will be presented to you to read at your first appointment. To save some time on your first appointment, you can read these ahead of time.

 

Notice of Privacy Practices

Patient Rights

Dental Material Fact Sheet Booklet

Consent for xrays, exam and cleaning

 

Connect With Us

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Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.

Ready to come in for an appointment?
Contact us today!

Victoria Village Dentistry
Dan Nguyen, DDS
Quality Service You Can Trust

Rancho Cucamonga Dentist, Dr. Dan Nguyen is dedicated to excellence in general dentistry such as cleanings, restorations, and maintenance.


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