Provider Demographics
NPI:1427546910
Name:CROSS, CHELSEA LYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LYN
Last Name:CROSS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W CROSS ST APT 225
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-3662
Mailing Address - Country:US
Mailing Address - Phone:410-615-3833
Mailing Address - Fax:
Practice Address - Street 1:1327 SULPHUR SPRING RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-2747
Practice Address - Country:US
Practice Address - Phone:410-242-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD168551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice