Provider Demographics
NPI:1730528019
Name:DREIER, BRANDON EUGENE (DMD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:EUGENE
Last Name:DREIER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 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:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001416-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice