Organization

Thomas C. Kelley Dds Msd Llc

Periodontist in Brookfield, WI(View on Map)

Legal Business Name

Thomas C. Kelley Dds Msd Llc

NPI Number

1780998997

NPI Type

Organization

Enumeration Date

07/29/2010

Specialties

(Taxonomies)

Code

1223P0300X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

5257015

Contact
Information

Purpose

Mailing
Location

Address

17280 W NORTH AVE STE 203
17280 W NORTH AVE STE 203

City

Brookfield
Brookfield

State

WI
WI

Postal Code

53045-4366
53045-4366

Country

US
US

Telephone Number

(262) 787-9075
(262) 787-9075

Authorized Official

Name

Dr. Thomas Kelley

Title or Position

PERIODONTIST

Telephone Number

(262) 787-9075

Identifiers

Identifier

33778000

Identifier State

WI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/29/2010

Provider Address

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Organization

Meridian Endodontics And Periodontics

Brookfield, WI

Specialties: Endodontist (Primary)Periodontist

Organization

Dcp Of Brookfield Square, Llc

May also be known as Dentalworks Of Brookfield
Brookfield, WI

Specialties: General Practice Dentistry (Primary)DentistEndodontistOral and Maxillofacial Surgery (Dentist)Orthodontics and Dentofacial Orthopedic DentistPediatric DentistPeriodontistProsthodontist