Medical school: GEORGIA REGENTS UNIVERSITY COLLEGE OF DENTAL MEDICINE
Graduated: 2013
Also: ORAL SURGERY
NPI: 1316176944
Practice Locations (1)
OHIO STATE DENTAL FACULTY PRACTICE INC
305 W 12TH AVE
COLUMBUS, OH 432101267
6142921472
Source: CMS National Downloadable File, September 2026.