Provider Demographics
NPI:1477793297
Name:NURELL, ALEXANDER S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:S
Last Name:NURELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-2005
Mailing Address - Country:US
Mailing Address - Phone:407-629-6464
Mailing Address - Fax:407-629-0031
Practice Address - Street 1:2715 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-2005
Practice Address - Country:US
Practice Address - Phone:407-629-6464
Practice Address - Fax:407-629-0031
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL091161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry