Individual
TERRY A SELLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30 N SLUSSER ST, GRAYSLAKE, IL 60030-3662
(847) 223-2876
(847) 223-2807
Mailing address
30 N SLUSSER ST, GRAYSLAKE, IL 60030-3662
(847) 223-2876
(847) 223-2807
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019.014156
IL
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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