NPI 1003214875

Innovative Dental Services, P.C.

Organisation Dentist Philadelphia, PA

Practice location

Address: 7234 Rising Sun Ave, Philadelphia, PA 19111-3948
Phone: (215) 745-4313
Fax: (215) 745-4388

Authorised official

Name: Olga Kandov
Title: Owner
Phone: (215) 745-4313

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence DS037628 (PA)

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Registry record

NPI: 1003214875
Entity type: Organization
NPI issued: 10 Dec 2014
Record last updated: 10 Dec 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.