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General NPI Number Information
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NPI Number | 1972414316
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Entity Type | Organization
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Legal Business Name | PIRATE PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 1169 FM 43
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City | CORPUS CHRISTI
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State | TX
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Zip | 78415
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Country | US
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Telephone | 361-733-3273
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Fax |
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Provider Business Mailing Address
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Address Line | 1602 GEMINI ACRES ST
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City | CORPUS CHRISTI
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State | TX
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Zip | 78415-1553
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Country | US
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Telephone | 361-733-3273
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROSANNA PUENTE WHIDDEN
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Credential | DDS
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Telephone | 361-733-3273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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