Provider Demographics
NPI:1235578667
Name:WHIDDEN, ROSANNA PUENTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:PUENTE
Last Name:WHIDDEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6200 SARATOGA BLVD
Mailing Address - Street 2:BLDG 1
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3477
Mailing Address - Country:US
Mailing Address - Phone:361-992-9500
Mailing Address - Fax:
Practice Address - Street 1:6200 SARATOGA BLVD
Practice Address - Street 2:BLDG 1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3477
Practice Address - Country:US
Practice Address - Phone:361-992-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305121223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry