Provider Demographics
NPI:1346975687
Name:KENNETH H. RETFORD DDS, PLLC
Entity Type:Organization
Organization Name:KENNETH H. RETFORD DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:RETFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-771-6210
Mailing Address - Street 1:29856 SCHOENHERR RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3600
Mailing Address - Country:US
Mailing Address - Phone:586-771-6210
Mailing Address - Fax:586-771-6229
Practice Address - Street 1:29856 SCHOENHERR RD STE 1
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3600
Practice Address - Country:US
Practice Address - Phone:586-771-6210
Practice Address - Fax:586-771-6229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental