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General NPI Number Information
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NPI Number | 1548279730
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Entity Type | Individual
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Provider Name | TONIQUE L. REYNOLDS-MORGAN DMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1846 OLD NORCROSS RD STE 300
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044
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Country | US
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Telephone | 770-822-9500
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Fax | 770-822-9545
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Provider Business Mailing Address
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Address Line | 1620 RIVERPARK DR
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City | DACULA
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State | GA
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Zip | 30019-7611
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Country | US
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Telephone | 770-243-3299
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Fax | 770-822-9545
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN012982
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License Number State | GA
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