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General NPI Number Information
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NPI Number | 1023982451
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Entity Type | Organization
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Legal Business Name | PLATEAU FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1357 INTERSTATE DR
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City | CROSSVILLE
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State | TN
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Zip | 38555-6184
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Country | US
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Telephone | 931-787-1277
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Fax | 931-787-1257
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Provider Business Mailing Address
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Address Line | 1357 INTERSTATE DR
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City | CROSSVILLE
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State | TN
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Zip | 38555-6184
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Country | US
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Telephone | 931-787-1277
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Fax | 931-787-1257
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Authorized Official
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Title or Position | RDH, OM
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Name | TIFFANY A AUSTIN
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Credential | RDH, OM
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Telephone | 931-787-1277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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