Medical school: NOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE
Graduated: 2015
NPI: 1922471234
Practice Locations (4)
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 JOHNSON FERRY NE
ATLANTA, GA 303421606
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 JOHNSON FERRY RD NE
ATLANTA, GA 303421606
4048518000
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 MEDICAL CTR BLVD
LAWRENCEVILLE, GA 300467694
6783123294
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
631 PROFESSIONAL DR
LAWRENCEVILLE, GA 300463392
Source: CMS National Downloadable File, September 2026.