Provider Demographics
NPI:1639870090
Name:GOSSETT, ANNETTE (RDH)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:GOSSETT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12513 AMBERSET DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-5372
Mailing Address - Country:US
Mailing Address - Phone:812-239-2935
Mailing Address - Fax:
Practice Address - Street 1:11840 KINGSTON PIKE STE A
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3836
Practice Address - Country:US
Practice Address - Phone:865-658-8803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000010141124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist