MEDICARE: HEATHER DIULIO 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	122300000X	Dentist	29898	TX
2	122300000X	Dentist	6896	NV

General Provider Information

NPI Number	:	1316359813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER DIULIO DMD

Provider Business Mailing Address
First Line	:	2250 S RANCHO DR
Second Line	:	SUITE 205
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4451
Country	:	US
Telephone Number	:	702-291-2031
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 S RANCHO DR
Second Line	:	SUITE 205
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4451
Country	:	US
Telephone Number	:	702-291-2031
Fax Number	:

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

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	05/09/2017

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Directions to “ HEATHER DIULIO DMD” Practice Location

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