Provider Demographics
NPI:1316359813
Name:DIULIO, HEATHER (DMD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DIULIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:DREBITKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2250 S RANCHO DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4451
Mailing Address - Country:US
Mailing Address - Phone:702-291-2031
Mailing Address - Fax:
Practice Address - Street 1:2250 S RANCHO DR
Practice Address - Street 2:SUITE 205
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4451
Practice Address - Country:US
Practice Address - Phone:702-291-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29898122300000X
NV6896122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist