Provider Demographics
NPI:1023982451
Name:PLATEAU FAMILY DENTISTRY
Entity type:Organization
Organization Name:PLATEAU FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RDH, OM
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:A
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH, OM
Authorized Official - Phone:931-787-1277
Mailing Address - Street 1:1357 INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-6184
Mailing Address - Country:US
Mailing Address - Phone:931-787-1277
Mailing Address - Fax:931-787-1257
Practice Address - Street 1:1357 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-6184
Practice Address - Country:US
Practice Address - Phone:931-787-1277
Practice Address - Fax:931-787-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty