Provider Demographics
NPI:1386770329
Name:SONNEVELD, THOMAS CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CRAIG
Last Name:SONNEVELD
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 1:9641 W 153RD ST STE 50
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3777
Mailing Address - Country:US
Mailing Address - Phone:708-403-2626
Mailing Address - Fax:
Practice Address - Street 1:9641 W 153RD ST STE 50
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3777
Practice Address - Country:US
Practice Address - Phone:708-403-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics