Provider Demographics
NPI:1245221597
Name:LOREI, BRIAN JOSEPH (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:LOREI
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7677 MISSION GORGE RD UNIT 142
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-1366
Mailing Address - Country:US
Mailing Address - Phone:814-774-8154
Mailing Address - Fax:
Practice Address - Street 1:7677 MISSION GORGE RD UNIT 142
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-1366
Practice Address - Country:US
Practice Address - Phone:814-774-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0353841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics