Medical school: OHIO STATE UNIVERSITY COLLEGE OF DENTISTRY
Graduated: 1998
NPI: 1083785091
Practice Locations (1)
EAST TENNESSEE ORAL AND MAXILLOFACIAL SURGERY, PC
1505 E LAMAR ALEXANDER PKWY
MARYVILLE, TN 378045131
8659838630
Source: CMS National Downloadable File, September 2026.