MEDICARE: DR. NATALIE VASILIKI SLADE D.D.S.

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	122300000X	Dentist	30.021332	OH

General Provider Information

NPI Number	:	1578602678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALIE VASILIKI SLADE D.D.S.

Provider Business Mailing Address
First Line	:	7212 TAYLORSVILLE RD
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2303
Country	:	US
Telephone Number	:	937-233-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7212 TAYLORSVILLE RD
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2303
Country	:	US
Telephone Number	:	937-233-6500
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/03/2017

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