Provider Demographics
NPI:1003270869
Name:RETRO DENTAL GROUP HIGHLANDS
Entity Type:Organization
Organization Name:RETRO DENTAL GROUP HIGHLANDS
Other - Org Name:RETRO DENTAL GROUP HIGHLANDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-681-7700
Mailing Address - Street 1:3025 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2001
Mailing Address - Country:US
Mailing Address - Phone:818-681-7700
Mailing Address - Fax:
Practice Address - Street 1:3025 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2001
Practice Address - Country:US
Practice Address - Phone:818-681-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental