Provider Demographics
NPI:1982651295
Name:ANNONI, BRET DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRET
Middle Name:DAVID
Last Name:ANNONI
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 1:1855 SAN MIGUEL DR
Mailing Address - Street 2:SUITE 20
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5279
Mailing Address - Country:US
Mailing Address - Phone:925-934-3892
Mailing Address - Fax:
Practice Address - Street 1:1855 SAN MIGUEL DR
Practice Address - Street 2:SUITE 20
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5279
Practice Address - Country:US
Practice Address - Phone:925-934-3892
Practice Address - Fax:925-934-3606
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice