Medical school: UNIV OF CALIF, LOS ANGELES SCHOOL OF DENTISTRY
Graduated: 1989
Also: ORAL SURGERY
NPI: 1356322838
Practice Locations (1)
3237 E SUNSHINE ST B, ORAL SURGERY OF SPRINGFIELD
SPRINGFIELD, MO 658046919
4178814546
Source: CMS National Downloadable File, September 2026.