| Kent R Wildern Dds Pc | |
|
4701 Plainfield Ave Ne Grand Rapids MI 49525-1644 | |
| (616) 364-8716 | |
| (616) 364-8716 |
| Full Name | Kent R Wildern Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4701 Plainfield Ave Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kent Raymond Wildern (OWNER) |
| Authorized Official Contact | 6163648716 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kent R Wildern Dds Pc 4701 Plainfield Ave Ne Grand Rapids MI 49525-1644 Ph: (616) 364-8716 | Kent R Wildern Dds Pc 4701 Plainfield Ave Ne Grand Rapids MI 49525-1644 Ph: (616) 364-8716 |
| NPI Number | 1750803300 |
|---|---|
| Provider Enumeration Date | 07/14/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750803300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Michigan) | Primary |
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