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General NPI Number Information
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NPI Number | 1699420166
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Entity Type | Individual
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Provider Name | QUODARRIUS MARCELL TONEY DDS
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Gender | Male
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 3100 PROFESSIONAL PLZ
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City | GERMANTOWN
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State | TN
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Zip | 38138-7915
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Country | US
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Telephone | 901-295-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 9124 STONEDALE DR
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City | CORDOVA
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State | TN
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Zip | 38018-7501
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Country | US
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Telephone | 901-604-1602
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 11574
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License Number State | TN
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