Healthcare Provider Details

I. General information

NPI: 1154233047
Provider Name (Legal Business Name): MORROW FAMILY DENTISTRY II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6319 JONESBORO RD STE A
MORROW GA
30260-1786
US

IV. Provider business mailing address

50 GLENLAKE PKWY STE 550
SANDY SPRINGS GA
30328-7242
US

V. Phone/Fax

Practice location:
  • Phone: 770-570-9769
  • Fax:
Mailing address:
  • Phone: 770-570-9769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JACKSON REID TRALONGO
Title or Position: PRESIDENT
Credential:
Phone: 770-570-9769