MEDICARE: ADITI GARG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	33356	TX

General Provider Information

NPI Number	:	1932635430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADITI GARG

Provider Business Mailing Address
First Line	:	215 GREENBRIER DR
Second Line	:
City	:	BYESVILLE
State	:	OH
Zip	:	43723-9513
Country	:	US
Telephone Number	:	415-688-9941
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 GREGORY ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-1614
Country	:	US
Telephone Number	:	940-228-1508
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2017
Last Update Date	:	07/21/2017

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Directions to “ ADITI GARG ” Practice Location

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