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Individual

DR. JACK BRIAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
160 THREE RIVERS DR NE, STE. 1600, ROME, GA 30161-2303
(706) 291-0095
(706) 291-0036
Mailing address
41 DOVER DR SE, ROME, GA 30161-8015
(423) 309-6816

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN012910
GA

Other

Enumeration date
02/01/2007
Last updated
07/08/2007
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