Kelley, Thomas Christopher

Kelley, Thomas Christopher is an individual health care provider with primary practice located at 150 S Calhoun Rd , Brookfield WI 53005-6303. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Kelley, Thomas Christopher can be contacted via phone (262) 787-9075.

Contact Information

Primary practice address
150 S Calhoun Rd Brookfield WI 53005-6303
Phone: (262) 787-9075
Fax: (262) 787-9076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 5257015 Wisconsin

Profile Details

NPI number 1770572828
LBN Legal business name Kelley, Thomas Christopher
Credentials DDS, MSD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770572828 NPPES
Wisconsin MEDICAID 33778000

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