Provider Demographics
NPI:1689844722
Name:TERRELL, CHERYL
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:TERRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10274 LAKE ARBOR WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3146
Mailing Address - Country:US
Mailing Address - Phone:301-808-3909
Mailing Address - Fax:301-808-3908
Practice Address - Street 1:10274 LAKE ARBOR WAY STE 203
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-3146
Practice Address - Country:US
Practice Address - Phone:301-808-3909
Practice Address - Fax:301-808-3908
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135461223G0001X
MD126201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice