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Police in the northern US state said the shooter first rammed the church with his vehicle before opening fire with an assault rifle, and then set the building aflame. The attacker was killed by police in the parking lot eight minutes after the first emergency call came in.
In addition to two deceased victims announced earlier in the day, two more bodies had been recovered among debris at the burned-down church, with search efforts ongoing. Earlier, eight people had also been wounded in the attack, one of whom was in critical condition.
Officials did not provide any further details on Sanford. US media reports said he had grown up in the area and was a military veteran.
Images of the aftermath at the Church of Jesus Christ of Latter-day Saints in Grand Blanc, a suburb of Flint, showed most of the building reduced to ashes. Photos also showed the truck apparently driven by the attacker into the side of the building, with two US flags mounted on poles in its rear.
Trump called the shooting "horrendous" and described it as "yet another targeted attack on Christians in the United States of America."