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Organization
MID AMERICA GROUP OF GEORGIA PC
Active
Organization
MID AMERICA GROUP OF GEORGIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEWEL BERNADETTE SMITH DDS (OWNER)
(317) 886-6639
Entity
Organization
Contact information
Practice address
160 CLAIREMONT AVE, STE 200, DECATUR, GA 30030-2546
(317) 886-6637
(888) 547-0377
Mailing address
1499 WINDHORST WAY, STE 100, GREENWOOD, IN 46143-8800
(317) 886-6639
(888) 547-0377
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/19/2013
Last updated
03/19/2014
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