Healthcare Provider Details

I. General information

NPI: 1770494544
Provider Name (Legal Business Name): OLD TOWN DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20406 BRIAN WAY # 2
TEHACHAPI CA
93561-8781
US

IV. Provider business mailing address

20406 BRIAN WAY # 2
TEHACHAPI CA
93561-8781
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-6706
  • Fax:
Mailing address:
  • Phone: 661-822-6706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNE BRETT
Title or Position: OWNER
Credential: DDS
Phone: 760-985-0737