Individual
DR. THOMAS CHRISTOPHER KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
150 S CALHOUN RD, BROOKFIELD, WI 53005-6303
(262) 787-9075
(262) 787-9076
Mailing address
150 S CALHOUN RD, BROOKFIELD, WI 53005-6303
(262) 787-9075
(262) 787-9076
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5257015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33778000
—
WI
Enumeration date
10/20/2005
Last updated
07/08/2007
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