MEDICARE: MRS. NATALIE SUZANNE GAIDA 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	122300000X	Dentist	2901019399	MI

General Provider Information

NPI Number	:	1962502237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE SUZANNE GAIDA DDS

Provider Business Mailing Address
First Line	:	9183 LAKE RIDGE DR
Second Line	:
City	:	CLARKSTON
State	:	MI
Zip	:	48348
Country	:	US
Telephone Number	:	248-953-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	606 N MAIN ST
Second Line	:
City	:	ALMONT
State	:	MI
Zip	:	48003-0465
Country	:	US
Telephone Number	:	810-798-8585
Fax Number	:	810-798-2381

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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