MEDICARE: RICHARD BRADLEY GAIK DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2000158413	MO

General Provider Information

NPI Number	:	1538262688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD BRADLEY GAIK DDS

Provider Business Mailing Address
First Line	:	8568 N CHURCH RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158
Country	:	US
Telephone Number	:	816-792-0801
Fax Number	:	816-415-2795

Provider Business Practice Location Address
First Line	:	8568 N CHURCH RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158
Country	:	US
Telephone Number	:	816-792-0801
Fax Number	:	816-415-2795

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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