Medical school: INDIANA UNIVERSITY SCHOOL OF DENTISTRY
Graduated: 1996
NPI: 1093828238
Practice Locations (3)
3535 ROSWELL RD, SUITE 55
MARIETTA, GA 300626252
1415 3RD ST SE
Moultrie, GA 317685920
1415 3RD ST SE
MOULTRIE, GA 317685920
Source: CMS National Downloadable File, September 2026.