MEDICARE: LIANNA ZABANAL 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	32265	TX

General Provider Information

NPI Number	:	1740738954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANNA ZABANAL DDS

Provider Business Mailing Address
First Line	:	3120 RED MAPLE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4584
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3110 TRAWOOD DR STE D
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-3842
Country	:	US
Telephone Number	:	915-855-1000
Fax Number	:

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

Provider Enumeration Date	:	09/16/2016
Last Update Date	:	12/22/2020

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