Provider Demographics
NPI:1144315862
Name:HEIL, AMY M (DMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:HEIL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9405 WANDERING WOODS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-1618
Mailing Address - Country:US
Mailing Address - Phone:702-564-4301
Mailing Address - Fax:702-939-4360
Practice Address - Street 1:4760 S PECOS RD
Practice Address - Street 2:103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5828
Practice Address - Country:US
Practice Address - Phone:800-409-2563
Practice Address - Fax:623-321-6268
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV51061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice