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Organization
MICHEL MARIE WICKSALL DDS PLC
Active
Organization
MICHEL MARIE WICKSALL DDS PLC
Active
Other names
Michel Marie Wicksall DDS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHEL WICKSALL (OWNER)
(616) 975-9700
Entity
Organization
Contact information
Practice address
4880 CASCADE RD SE STE B, GRAND RAPIDS, MI 49546-3701
(616) 975-9700
(616) 975-9750
Mailing address
4880 CASCADE RD SE STE B, GRAND RAPIDS, MI 49546-3701
(616) 975-9700
(616) 975-9750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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