Provider Demographics
NPI:1174732721
Name:BURDETTE, ROCHELLE DENISE (DDS)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:DENISE
Last Name:BURDETTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 VAUGHN CREST DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7212
Mailing Address - Country:US
Mailing Address - Phone:310-795-6656
Mailing Address - Fax:615-370-1323
Practice Address - Street 1:1041 VAUGHN CREST DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-7212
Practice Address - Country:US
Practice Address - Phone:310-795-6656
Practice Address - Fax:615-370-1323
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000008723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist