Provider Demographics
NPI:1184749616
Name:CROSS, NYLA GREER (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:NYLA
Middle Name:GREER
Last Name:CROSS
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CALDWELL LN
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-4070
Mailing Address - Country:US
Mailing Address - Phone:423-569-6368
Mailing Address - Fax:423-569-1503
Practice Address - Street 1:116 CALDWELL LN
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-4070
Practice Address - Country:US
Practice Address - Phone:423-569-6368
Practice Address - Fax:423-569-1503
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS34461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics