Provider Demographics
NPI:1366558439
Name:TRAGESSER, LARRY E (DDS)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:E
Last Name:TRAGESSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5213
Mailing Address - Country:US
Mailing Address - Phone:865-693-1047
Mailing Address - Fax:865-693-6602
Practice Address - Street 1:9000 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5213
Practice Address - Country:US
Practice Address - Phone:865-693-1047
Practice Address - Fax:865-693-6602
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3038122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist