NPI | 1053984591 |
---|---|
Doing Business As | MICHEL MARIE WICKSALL DDS |
Entity Type | Organization |
Authorized Contact | MICHEL WICKSALL Owner 616-975-9700 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-07-22 |
Last Update Date | 2021-07-22 |