Provider Demographics
NPI:1780608927
Name:SELLETT, THOMAS CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHARLES
Last Name:SELLETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 E HIGGINS RD
Mailing Address - Street 2:SUITE 152
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4799
Mailing Address - Country:US
Mailing Address - Phone:847-517-7500
Mailing Address - Fax:847-517-7501
Practice Address - Street 1:890 E HIGGINS RD
Practice Address - Street 2:SUITE 152
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4799
Practice Address - Country:US
Practice Address - Phone:847-517-7500
Practice Address - Fax:847-517-7501
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice