Provider Demographics
NPI:1740430685
Name:TRIVETTE AND OSBORNE, PLLC
Entity Type:Organization
Organization Name:TRIVETTE AND OSBORNE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:865-687-3203
Mailing Address - Street 1:2931 ESSARY RD
Mailing Address - Street 2:STE 1
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2404
Mailing Address - Country:US
Mailing Address - Phone:865-687-3203
Mailing Address - Fax:865-687-3299
Practice Address - Street 1:2931 ESSARY RD STE 1
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2404
Practice Address - Country:US
Practice Address - Phone:865-687-3203
Practice Address - Fax:865-687-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000005136261QD0000X
TNDS0000005028261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental