Organization
INNOVATIVE DENTAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLGA KANDOV DMD (OWNER)
(215) 745-4313
Entity
Organization
Contact information
Practice address
7234 RISING SUN AVE, PHILADELPHIA, PA 19111-3948
(215) 745-4313
(215) 745-4388
Mailing address
7234 RISING SUN AVE, PHILADELPHIA, PA 19111-3948
(215) 745-4313
(215) 745-4388
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS037628
PA
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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