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General NPI Number Information
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NPI Number | 1487847455
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Entity Type | Organization
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Legal Business Name | LARRY E TRAGESSER DDS
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 9000 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37923-5230
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Country | US
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Telephone | 865-693-1047
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Fax | 865-693-6602
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Provider Business Mailing Address
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Address Line | 9000 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37923-5230
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Country | US
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Telephone | 865-693-1047
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Fax | 865-693-6602
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SONYA SHERRILL
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Credential |
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Telephone | 865-693-1047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 3038
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License Number State | TN
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