Provider Demographics
NPI:1831497502
Name:TERRELL, BRITTANY ELIZABETH (DA)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:ELIZABETH
Last Name:TERRELL
Suffix:
Gender:F
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 WINDERMERE PKWY
Mailing Address - Street 2:3810 WINDERMERE PARKWAY
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6103
Mailing Address - Country:US
Mailing Address - Phone:770-889-9600
Mailing Address - Fax:
Practice Address - Street 1:3810 WINDERMERE PKWY
Practice Address - Street 2:501
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6103
Practice Address - Country:US
Practice Address - Phone:770-889-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant