Medical school: SOUTHERN ILLINOIS UNIV SCHOOL OF DENTAL MEDICINE
Graduated: 2007
Also: DENTIST
NPI: 1386883593
Practice Locations (2)
124 SW ADAMS ST
PEORIA, IL 616021308
530 NE GLEN OAK AVE
PEORIA, IL 616370001
Source: CMS National Downloadable File, September 2026.