Thomas J. Kepic, D.D.S., M.S.D.
Diplomate: American Board of Periodontology
250 East 7th St., Suite D
Upland, CA  91786

Specialist in Periodontics
 with services in implants

Phone: 909-982-4169 Fax: 909-981-2149
E-Mail:
thedoctor@TomKepic.com

New Patients

 
As a new patient, it helps us to know more about you and your current dental condition. Get a head-start by downloading our online patient information form, printing it, and filling it out before your appointment. This PDF form can be opened with Adobe Acrobat Reader 5.0 or later (free if you don't already have it).

Just fill out the form and print it!

The form can be mailed or faxed.

See address and fax number above.