Provider Demographics
NPI:1639499155
Name:NAYLOR, NICOLE RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:RENEE
Last Name:NAYLOR
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 1:298 N HIGHWAY 16
Mailing Address - Street 2:SUITE E
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8480
Mailing Address - Country:US
Mailing Address - Phone:704-483-1870
Mailing Address - Fax:704-483-1221
Practice Address - Street 1:298 N HIGHWAY 16
Practice Address - Street 2:SUITE E
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8480
Practice Address - Country:US
Practice Address - Phone:704-483-1870
Practice Address - Fax:704-483-1221
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8953122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8958OtherDENTAL LICENSE NUMBER