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Organization
SALT RUN FAMILY DENTISTRY, LLC
Active
Organization
SALT RUN FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT MICHAEL LETH II DMD (OWNER)
(904) 824-3540
Entity
Organization
Contact information
Practice address
700 ANASTASIA BLVD, SAINT AUGUSTINE, FL 32080-4616
(904) 824-3540
(904) 824-3541
Mailing address
700 ANASTASIA BLVD, SAINT AUGUSTINE, FL 32080-4616
(904) 824-3540
(904) 824-3541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN18649
FL
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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