Organization
INNOVA DENTAL SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MADHAVI KUNDURU (OFFICE MANAGER)
(732) 364-1700
Entity
Organization
Contact information
Practice address
155 S NEW PROSPECT RD, JACKSON, NJ 08527-1734
(732) 364-1700
(732) 364-0870
Mailing address
155 S NEW PROSPECT RD, JACKSON, NJ 08527-1734
(732) 364-1700
(732) 364-0870
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02567701
NJ
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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