Brian J. Kim, DDS, MSD

Experience a life-changing smile

(818) 363-7900 / (661) 310-4985

Granada Hills Office 10515 Balboa Blvd., Ste 280, Granada Hills, CA 91344
Valencia Office 23501 Cinema Dr. Suite 114, Valencia, CA 91355

Doctor Referrals

Office Locations | Appointment Request | Comment Form | Refer a Friend | Doctor Referrals

Thank you for entrusting us with the care of your patients. We know that your patients are very important, and we truly appreciate the confidence you show in us by your referral.

Doctor Referral Form

If you are a doctor who is referring a patient to us, please fill out and submit the following form.

Your Information:

Your Name:

First

Last
Your Practice Name:

Full Practice Name
Email Address

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Referral Information:

Name of Person You're Referring:

First

Last
Were Radiographs Sent?

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When were they sent?
Additional Information:

Comments:

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