Provider Demographics
NPI:1538389671
Name:DIGIULIO, YOLIMAR CANAHUATE (DMD)
Entity type:Individual
Prefix:DR
First Name:YOLIMAR
Middle Name:CANAHUATE
Last Name:DIGIULIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 NW SANDALWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-5477
Mailing Address - Country:US
Mailing Address - Phone:541-678-5322
Mailing Address - Fax:
Practice Address - Street 1:1470 SW KNOLL AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3186
Practice Address - Country:US
Practice Address - Phone:541-719-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD88681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice