Provider Demographics
NPI:1376092551
Name:FLAHERTY AND SAULS DENTISTRY, PLLC
Entity Type:Organization
Organization Name:FLAHERTY AND SAULS DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SAULS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:276-698-0574
Mailing Address - Street 1:3035 MAGNOLIA BND
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8295
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8260 SEMINOLE TRL
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-3492
Practice Address - Country:US
Practice Address - Phone:434-987-7891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413286261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental