Provider Demographics
NPI:1245443050
Name:BRITE DENTAL CARE, P.C.
Entity type:Organization
Organization Name:BRITE DENTAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZETOUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-354-9500
Mailing Address - Street 1:8012 SHELDON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1800
Mailing Address - Country:US
Mailing Address - Phone:734-354-9500
Mailing Address - Fax:
Practice Address - Street 1:8012 SHELDON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1800
Practice Address - Country:US
Practice Address - Phone:734-354-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI169081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4976605Medicaid