Organization
SALT OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN DUNN OPTICIAN MASTER (MANAGER)
(214) 663-4238
Entity
Organization
Contact information
Practice address
9 JAMIE CT, TROPHY CLUB, TX 76262-6709
(972) 629-9853
Mailing address
4628 BRIMSTONE DR, FORT WORTH, TX 76244-6983
(972) 629-9853
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
7084676TX
TX
Other
Enumeration date
04/09/2017
Last updated
04/09/2017
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