Medical school: AT STILL UNIVERSITY, ARIZONA SCHOOL OF DENTISTRY & ORAL HLTH
Graduated: 2009
NPI: 1417056201
Practice Locations (2)
5513 N GLENWOOD ST, SUITE B
BOISE, ID 837141332
2083756600
1032 S SILVERSTONE WAY, SUITE 160
MERIDIAN, ID 836421080
2086580238
Source: CMS National Downloadable File, September 2026.