Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michel Marie Wicksall DDS PLC

Organization General Practice Dentistry · NPI 1053984591

Michel Marie Wicksall DDS PLC is a General Practice Dentistry in Grand Rapids, Michigan. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

4880 Cascade Rd SE Ste B
Grand Rapids, MI 49546-3701
Phone: (616) 975-9700
Fax: (616) 975-9750
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1053984591
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michel Wicksall — Owner · (616) 975-9700
Other names Michel Marie Wicksall Dds
NPI enumeratedJuly 22, 2021
Last updated in NPPESJuly 22, 2021
Certification dateJuly 22, 2021
Mailing address4880 Cascade Rd Se Ste B, Grand Rapids, MI 49546-3701

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