# LTH DENTAL GROUP 1 PLLC

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

## Provider details

- **NPI number:** 1275248056
- **Authorized official:** DR. JUSTIN A LEATH DDS (CEO)
- **Authorized official phone:** (586) 365-9451

## Contact information

- **Practice address:** 192 W. HIGHLAND RD., HIGHLAND, MI 48357
- **Practice address phone:** (586) 365-9451
- **Mailing address:** 5880 STONEHAVEN BLVD, ROCHESTER, MI 48306-4941
- **Mailing address phone:** (586) 365-9451

## Taxonomy

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

## Other

- **Enumeration date:** 01/17/2023
- **Last updated:** 01/17/2023