Individual
WYLAND WILSON GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2139 WILDFIELD DR NE, GRAND RAPIDS, MI 49505-6321
(616) 361-8506
Mailing address
2139 WILDFIELD DR NE, GRAND RAPIDS, MI 49505-6321
(616) 361-8506
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901007648
MI
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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