Provider Demographics
NPI:1891724464
Name:TERRELL, KEVIN BOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BOYD
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 1:4616 W LOVERS LN
Mailing Address - Street 2:#212
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-3101
Mailing Address - Country:US
Mailing Address - Phone:214-244-1370
Mailing Address - Fax:
Practice Address - Street 1:4616 W LOVERS LN
Practice Address - Street 2:#212
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-3101
Practice Address - Country:US
Practice Address - Phone:214-244-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18200OtherDDS LICENSE