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Organization
KENT R WILDERN DDS PC
Active
Organization
KENT R WILDERN DDS PC
Active
Parent organization
KENT R WILDERN DDS PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENT R WILDERN DDS PC
Authorized official
DR. KENT RAYMOND WILDERN DDS (OWNER)
(616) 364-8716
Entity
Organization
Contact information
Practice address
4701 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-1644
(616) 364-8716
(616) 364-8716
Mailing address
4701 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-1644
(616) 364-8716
(616) 364-8829
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
MI
Other
Enumeration date
07/14/2017
Last updated
07/21/2022
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