Dr. Kevin Dang & Dr. Cindy Dang

          Fort Smith Pavilion

          4189 Phoenix Avenue

          Fort Smith, AR. 72903

          Phone: 479-434-4668

          Fax: 479-434-3685

 

 

To order contact lens, either call us at 479-434-4668 or fill out this form . Incomplete answer will cause delay in ordering.

First Name

Last Name

Date of Birth

Address

City, State, Zip

Telephone

Email

Purchase supply   1 year   6 months    3 months

Delivery    Pick up at clinic       Mail ($4.50 charge)

 Additional request/information