Healthcare Provider Details

I. General information

NPI: 1669577599
Provider Name (Legal Business Name): BRUNO A GIGLIO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 METROPOLITAN PKWY
STERLING HEIGHTS MI
48310-3901
US

IV. Provider business mailing address

4515 METROPOLITAN PKWY
STERLING HEIGHTS MI
48310-3901
US

V. Phone/Fax

Practice location:
  • Phone: 586-254-3860
  • Fax: 586-254-6575
Mailing address:
  • Phone: 586-254-3860
  • Fax: 586-254-6575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number29010-16810
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: