Provider Demographics
NPI:1811021819
Name:SCHELL, THOMAS GERARD (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERARD
Last Name:SCHELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 WHITAKER RD.
Mailing Address - Street 2:PO BOX 127
Mailing Address - City:MERIDEN
Mailing Address - State:NH
Mailing Address - Zip Code:03770-0127
Mailing Address - Country:US
Mailing Address - Phone:603-469-3527
Mailing Address - Fax:603-448-3800
Practice Address - Street 1:31 OLD ETNA RD # N1
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1933
Practice Address - Country:US
Practice Address - Phone:603-448-3800
Practice Address - Fax:603-448-0553
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30313858Medicaid
NH30004439Medicaid