Provider Demographics
NPI:1730650730
Name:DREIER FAMILY DENTAL
Entity Type:Organization
Organization Name:DREIER FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DREIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:608-752-2931
Mailing Address - Street 1:2203 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-0317
Mailing Address - Country:US
Mailing Address - Phone:608-752-2931
Mailing Address - Fax:608-752-2455
Practice Address - Street 1:2203 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-0317
Practice Address - Country:US
Practice Address - Phone:608-752-2931
Practice Address - Fax:608-752-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental