NPI 1003501578

Nicole Ann Wilder, DDS

Practitioner General Practice Dentistry Plymouth, MI

Practice location

Address: 549 Provincetown Ln, Plymouth, MI 48170-1050
Phone: (810) 689-6261

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 2901601845 (MI)

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Registry record

NPI: 1003501578
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Apr 2023
Record last updated: 16 Nov 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.