# BRIGHT SIDE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013118330
- **Authorized official:** DR. DEREK GRYTZELIUS D.D.S. (DENTIST)
- **Authorized official phone:** (734) 591-4145

## Contact information

- **Practice address:** 16824 NEWBURGH RD, LIVONIA, MI 48154-1600
- **Practice address phone:** (734) 591-4145
- **Practice address fax:** (734) 591-4168
- **Mailing address:** 16824 NEWBURGH RD, LIVONIA, MI 48154-1600
- **Mailing address phone:** (734) 591-4145
- **Mailing address fax:** (734) 591-4168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 11295 | MI | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 08/22/2020