MEDICARE: AMY M HEIL DMD

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	5106	NV

General Provider Information

NPI Number	:	1144315862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY M HEIL DMD

Provider Business Mailing Address
First Line	:	9405 WANDERING WOODS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1618
Country	:	US
Telephone Number	:	702-564-4301
Fax Number	:	702-939-4360

Provider Business Practice Location Address
First Line	:	4760 S PECOS RD
Second Line	:	103
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5828
Country	:	US
Telephone Number	:	800-409-2563
Fax Number	:	623-321-6268

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/31/2013

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