Provider Demographics
NPI:1669577599
Name:GIGLIO, BRUNO A (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:A
Last Name:GIGLIO
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 METROPOLITAN PKWY
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3901
Mailing Address - Country:US
Mailing Address - Phone:586-254-3860
Mailing Address - Fax:586-254-6575
Practice Address - Street 1:4515 METROPOLITAN PKWY
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3901
Practice Address - Country:US
Practice Address - Phone:586-254-3860
Practice Address - Fax:586-254-6575
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010-16810122300000X
MI2091016810122300000X
MI2901016810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist