Organization
SMILES OF DECATUR P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUZARD BENJAMIN (CEO)
(770) 322-0059
Entity
Organization
Contact information
Practice address
2458 WESLEY CHAPEL RD STE B, DECATUR, GA 30035-3423
(770) 322-0059
Mailing address
2458 WESLEY CHAPEL RD STE B, DECATUR, GA 30035-3423
(770) 322-0059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
013549
GA
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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