Individual
DR. ALFRED DEPROPHETIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1440 CONCHESTER HIGHWAY, BOOTHWYN, PA 19061
(610) 459-4523
(610) 459-9716
Mailing address
1440 CONCHESTER HIGHWAY, BOOTHWYN, PA 19061
(610) 876-8117
(610) 459-9716
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS017875L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0699276
—
PA
Enumeration date
07/07/2006
Last updated
07/09/2007
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