# INNOVATIVE DENTAL SERVICES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003214875
- **Authorized official:** DR. OLGA KANDOV DMD (OWNER)
- **Authorized official phone:** (215) 745-4313

## Contact information

- **Practice address:** 7234 RISING SUN AVE, PHILADELPHIA, PA 19111-3948
- **Practice address phone:** (215) 745-4313
- **Practice address fax:** (215) 745-4388
- **Mailing address:** 7234 RISING SUN AVE, PHILADELPHIA, PA 19111-3948
- **Mailing address phone:** (215) 745-4313
- **Mailing address fax:** (215) 745-4388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS037628 | PA | Yes |

## Other

- **Enumeration date:** 12/10/2014
- **Last updated:** 12/10/2014