Provider Demographics
NPI:1548279730
Name:REYNOLDS-MORGAN, TONIQUE L (DMD)
Entity type:Individual
Prefix:DR
First Name:TONIQUE
Middle Name:L
Last Name:REYNOLDS-MORGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TONIQUE
Other - Middle Name:
Other - Last Name:REYNOLDS-MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 RIVERPARK DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7611
Mailing Address - Country:US
Mailing Address - Phone:770-243-3299
Mailing Address - Fax:770-822-9545
Practice Address - Street 1:1846 OLD NORCROSS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044
Practice Address - Country:US
Practice Address - Phone:770-822-9500
Practice Address - Fax:770-822-9545
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0129821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice