Provider Demographics
NPI:1558740217
Name:NAYLOR, MICAH DANIEL (DMD)
Entity Type:Individual
Prefix:
First Name:MICAH
Middle Name:DANIEL
Last Name:NAYLOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-2056
Mailing Address - Country:US
Mailing Address - Phone:704-263-4646
Mailing Address - Fax:704-263-4696
Practice Address - Street 1:510 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164-2056
Practice Address - Country:US
Practice Address - Phone:704-263-4646
Practice Address - Fax:704-263-4696
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist