MEDICARE: DR. SARAH DENISE PITARRA DDS

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	28990	TX

General Provider Information

NPI Number	:	1932547494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH DENISE PITARRA DDS

Provider Business Mailing Address
First Line	:	4758 MCARDLE
Second Line	:	SUITE 104
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-2509
Country	:	US
Telephone Number	:	361-855-7171
Fax Number	:	361-855-9223

Provider Business Practice Location Address
First Line	:	4758 MCARDLE
Second Line	:	SUITE 104
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-7841
Country	:	US
Telephone Number	:	361-855-7171
Fax Number	:	361-855-9223

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

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	05/26/2020

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