# INNOVA DENTAL SOLUTIONS

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

## Provider details

- **NPI number:** 1669912952
- **Authorized official:** MRS. MADHAVI KUNDURU (OFFICE MANAGER)
- **Authorized official phone:** (732) 364-1700

## Contact information

- **Practice address:** 155 S NEW PROSPECT RD, JACKSON, NJ 08527-1734
- **Practice address phone:** (732) 364-1700
- **Practice address fax:** (732) 364-0870
- **Mailing address:** 155 S NEW PROSPECT RD, JACKSON, NJ 08527-1734
- **Mailing address phone:** (732) 364-1700
- **Mailing address fax:** (732) 364-0870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22DI02567701 | NJ | Yes |

## Other

- **Enumeration date:** 03/06/2017
- **Last updated:** 03/06/2017