| Benjamin H Wickstra Dds Pllc | |
|
99 W 26th St Holland MI 49423-4970 | |
| (616) 218-5795 | |
| Not Available |
| Full Name | Benjamin H Wickstra Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 99 W 26th St, Holland, Michigan |
| Authorized Official Name and Position | Benjamin Wickstra (PRESIDENT) |
| Authorized Official Contact | 6162185795 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin H Wickstra Dds Pllc 567 Central Ave Holland MI 49423-4848 Ph: (616) 218-5795 | Benjamin H Wickstra Dds Pllc 99 W 26th St Holland MI 49423-4970 Ph: (616) 218-5795 |
| NPI Number | 1528344363 |
|---|---|
| Provider Enumeration Date | 10/25/2011 |
| Last Update Date | 10/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528344363 | NPI | - | NPPES |
| 1770763583 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Michigan) | Primary |
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