# LEGACY DENTAL GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. Andrew Lunn, DDS, Hixson Dental Groujp, Mountain View Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487432811
- **Authorized official:** MARCY KAY (INSURANCE ADMINISTRATOR)
- **Authorized official phone:** (423) 843-0418

## Contact information

- **Practice address:** 1605 WILLIAMS RD, HIXSON, TN 37343-4934
- **Practice address phone:** (423) 843-0418
- **Practice address fax:** (423) 842-7362
- **Mailing address:** 1605 WILLIAMS RD, HIXSON, TN 37343-4934
- **Mailing address phone:** (423) 843-0418
- **Mailing address fax:** (423) 842-7362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2023
- **Last updated:** 09/18/2023