MEDICARE: ZARAGOZA DENTISTRY PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1740873629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZARAGOZA DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	7965 CUSTER RD STE 140
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-3148
Country	:	US
Telephone Number	:	972-330-5878
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 N ZARAGOZA RD STE A101
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7905
Country	:	US
Telephone Number	:	915-440-6211
Fax Number	:	915-255-1945

Authorized Official
Title or Position	:	MEMBER MANAGER
Name	:	DR. ANDREW XU
Credential	:	DDS
Telephone Number	:	915-440-6211

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	02/11/2021

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Directions to “ZARAGOZA DENTISTRY PLLC ” Practice Location

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