# LEGACY DENTAL FAMILY AND IMPLANT DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639019342
- **Authorized official:** TIFFANY AUSTIN RDH, OM (RDH,OM)
- **Authorized official phone:** (931) 337-4447

## Contact information

- **Practice address:** 582 MILLER AVE STE 102, CROSSVILLE, TN 38555-4481
- **Practice address phone:** (931) 291-9144
- **Practice address fax:** (931) 202-8676
- **Mailing address:** 582 MILLER AVE STE 102, CROSSVILLE, TN 38555-4481
- **Mailing address phone:** (931) 291-9144
- **Mailing address fax:** (931) 202-8676

## Taxonomy

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

## Other

- **Enumeration date:** 03/31/2026
- **Last updated:** 03/31/2026