Organization
BRIGHT SIDE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GRYTZELIUS D.D.S. (DENTIST)
(734) 591-4145
Entity
Organization
Contact information
Practice address
16824 NEWBURGH RD, LIVONIA, MI 48154-1600
(734) 591-4145
(734) 591-4168
Mailing address
16824 NEWBURGH RD, LIVONIA, MI 48154-1600
(734) 591-4145
(734) 591-4168
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11295
MI
Other
Enumeration date
05/31/2007
Last updated
08/22/2020
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