| NPI | 1235497595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK GRYTZELIUS Owner/Doctor 586-439-2940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901018970) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |