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1780775130
LARRY WILDT
GRAND RAPIDS, MI
NPI
1780775130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MI 11365)
Enumeration Date
2006-09-28
Last Update Date
2007-07-08
Business Address
-- LARRY WILDT D.D.S
2515 ALPINE AVE NW SUITE A
GRAND RAPIDS, MI 49544-1924
Phone number: 616-364-9348
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Mailing Address
-- LARRY WILDT D.D.S
1344 WINTERWOOD DR NE
GRAND RAPIDS, MI 49525-3441
Phone number: 616-364-9348
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