Provider Demographics
NPI:1891878898
Name:ROOP, ROBIN ANN (DMD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANN
Last Name:ROOP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:1569 SMITH TWP STATE ROAD SUITE #1
Mailing Address - City:ATLASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15004
Mailing Address - Country:US
Mailing Address - Phone:724-947-9504
Mailing Address - Fax:724-947-9104
Practice Address - Street 1:1569 SMITH TOWNSHIP STATE ROAD
Practice Address - Street 2:SUITE #1
Practice Address - City:ATLASBURG
Practice Address - State:PA
Practice Address - Zip Code:15004
Practice Address - Country:US
Practice Address - Phone:724-947-9504
Practice Address - Fax:724-947-9104
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027723L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist