MEDICARE: MS. ROCHELLE DENISE BURDETTE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS0000008723	TN

General Provider Information

NPI Number	:	1174732721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROCHELLE DENISE BURDETTE D.D.S.

Provider Business Mailing Address
First Line	:	1041 VAUGHN CREST DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7212
Country	:	US
Telephone Number	:	310-795-6656
Fax Number	:	615-370-1323

Provider Business Practice Location Address
First Line	:	1041 VAUGHN CREST DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-7212
Country	:	US
Telephone Number	:	310-795-6656
Fax Number	:	615-370-1323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	04/15/2015

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