Organization
BRIGHT SIDE DENTAL-ST. CLAIR SHORES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GRYTZELIUS D.D.S. (OWNER/DOCTOR)
(586) 439-2940
Entity
Organization
Contact information
Practice address
31245 HARPER AVE, SAINT CLAIR SHORES, MI 48082-1401
(586) 439-2940
Mailing address
31245 HARPER AVE, SAINT CLAIR SHORES, MI 48082-1401
(586) 439-2940
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018970
MI
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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