Provider Demographics
NPI:1013222124
Name:DRAAYER, BRIAN D (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:DRAAYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 CENTRAL AVE
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-656-6100
Mailing Address - Fax:406-656-8726
Practice Address - Street 1:2900 CENTRAL AVE
Practice Address - Street 2:BUILDING 1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-8626
Practice Address - Country:US
Practice Address - Phone:406-656-6100
Practice Address - Fax:406-656-8726
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT24221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice