| Salt Run Family Dentistry, Llc | |
|
700 Anastasia Blvd Saint Augustine FL 32080-4616 | |
| (904) 824-3540 | |
| (904) 824-3541 |
| Full Name | Salt Run Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 700 Anastasia Blvd, Saint Augustine, Florida |
| Authorized Official Name and Position | Vincent Michael Leth (OWNER) |
| Authorized Official Contact | 9048243540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Salt Run Family Dentistry, Llc 700 Anastasia Blvd Saint Augustine FL 32080-4616 Ph: (904) 824-3540 | Salt Run Family Dentistry, Llc 700 Anastasia Blvd Saint Augustine FL 32080-4616 Ph: (904) 824-3540 |
| NPI Number | 1720463714 |
|---|---|
| Provider Enumeration Date | 07/20/2015 |
| Last Update Date | 07/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720463714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN18649 (Florida) | Primary |
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