Request an Appointment Thank you for your interest in Fountain Valley Dental Care. Please fill out the form below so one of our staff members can set up a date and time convenient for you. We take measures to ensure that your privacy is protected. Please read our privacy policy for more information.Name* First Last Email* Enter Email Confirm Email Phone*What search term did you use to find this website?*Please tell us the reason for your visit, or if you have any questions or concerns about your dental health that you would like addressed during your visit.Are you a new patient?*YesNoDid you check any online reviews to help you pick our dental office?YesNoHitsteps AnalyticsHitsteps Base ReferralHitsteps Most Recent External ReferralPhoneThis field is for validation purposes and should be left unchanged.