Medical school: SOUTHERN ILLINOIS UNIV SCHOOL OF DENTAL MEDICINE
Graduated: 2004
NPI: 1144423963
Practice Locations (2)
AFFILIATES IN ORAL AND MAXILLOFACIAL SURGERY LTD
3112 VILLAGE OFFICE PL
CHAMPAIGN, IL 618227680
2173517111
AFFILIATES IN ORAL AND MAXILLOFACIAL SURGERY LTD
3112 VILLAGE OFFICE PLACE
CHAMPAIGN, IL 618227680
Source: CMS National Downloadable File, September 2026.