Provider Demographics
NPI:1538056767
Name:TERRELL, ALEXANDER M (DDS)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:M
Last Name:TERRELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-3631
Mailing Address - Country:US
Mailing Address - Phone:563-508-7781
Mailing Address - Fax:
Practice Address - Street 1:1912 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7600
Practice Address - Country:US
Practice Address - Phone:563-355-5513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-103651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice