Provider Demographics
NPI:1427383991
Name:NORMAN, TONI MARIE (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:TONI
Middle Name:MARIE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:TONI
Other - Middle Name:MARIE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:619 SE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3234
Mailing Address - Country:US
Mailing Address - Phone:864-967-9700
Mailing Address - Fax:864-761-4623
Practice Address - Street 1:1108 N COURT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1612
Practice Address - Country:US
Practice Address - Phone:618-993-2872
Practice Address - Fax:618-997-7787
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190212601223X0400X
IL0210015471223X0400X
IADDS097191223X0400X
SC96851223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics