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General NPI Number Information
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NPI Number | 1962325464
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Entity Type | Organization
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Legal Business Name | SALT & LIGHT DENTAL CO. PLLC
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Dates
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Enumeration Date | 08/01/2026
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Last Update Date | 08/01/2026
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Provider Practice Location Address
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Address Line | 16226 REDSTONE WAY
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City | ODESSA
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State | FL
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Zip | 33556-4668
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Country | US
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Telephone | 813-838-9299
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST. PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNA KATRINA CANTA OLAES
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Credential |
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Telephone | 813-543-5878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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