Individual
DR. ADELINE PROPHETE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
780 RIDGE LAKE BLVD STE 201, MEMPHIS, TN 38120-9426
(901) 685-1003
(901) 531-8399
Mailing address
780 RIDGE LAKE BLVD STE 201, MEMPHIS, TN 38120-9426
(901) 685-1003
(901) 328-1566
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6897
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000669
—
TN
Enumeration date
10/26/2006
Last updated
03/15/2019
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