Provider Demographics
NPI:1265569107
Name:NAYLOR, ADAM EDWARD (DDS)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:EDWARD
Last Name:NAYLOR
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 1:518 N GENERALS BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3561
Mailing Address - Country:US
Mailing Address - Phone:704-748-1110
Mailing Address - Fax:
Practice Address - Street 1:518 N GENERALS BLVD STE F
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3561
Practice Address - Country:US
Practice Address - Phone:704-748-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5906431Medicaid