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General NPI Number Information
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NPI Number | 1396959151
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Entity Type | Organization
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Legal Business Name | BRIGHT POINTE, P.L.L.C
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 650 HURON BLVD
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City | MARYSVILLE
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State | MI
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Zip | 48040-1427
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Country | US
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Telephone | 810-364-9060
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Fax | 810-364-9117
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Provider Business Mailing Address
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Address Line | 650 HURON BLVD
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City | MARYSVILLE
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State | MI
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Zip | 48040-1427
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Country | US
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Telephone | 810-364-9060
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Fax | 810-364-9117
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE L. VREDENBURG
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Credential | D.D.S.
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Telephone | 810-364-9060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 015455
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License Number State | MI
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