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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