Provider Demographics
NPI:1962502237
Name:GAIDA, NATALIE SUZANNE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:SUZANNE
Last Name:GAIDA
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 1:9183 LAKE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348
Mailing Address - Country:US
Mailing Address - Phone:248-953-9000
Mailing Address - Fax:
Practice Address - Street 1:606 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALMONT
Practice Address - State:MI
Practice Address - Zip Code:48003-0465
Practice Address - Country:US
Practice Address - Phone:810-798-8585
Practice Address - Fax:810-798-2381
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist