Healthcare Provider Details

I. General information

NPI: 1962502237
Provider Name (Legal Business Name): NATALIE SUZANNE GAIDA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 N MAIN ST
ALMONT MI
48003-0465
US

IV. Provider business mailing address

9183 LAKE RIDGE DR
CLARKSTON MI
48348
US

V. Phone/Fax

Practice location:
  • Phone: 810-798-8585
  • Fax: 810-798-2381
Mailing address:
  • Phone: 248-953-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901019399
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: