Provider Demographics
NPI:1073920237
Name:GARG, ROOPAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROOPAM
Middle Name:
Last Name:GARG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 LONG PRAIRIE RD STE 132
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4295
Mailing Address - Country:US
Mailing Address - Phone:972-874-7870
Mailing Address - Fax:214-255-1120
Practice Address - Street 1:1900 LONG PRAIRIE RD STE 132
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4295
Practice Address - Country:US
Practice Address - Phone:972-874-7870
Practice Address - Fax:214-255-1120
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist