| Medella Dental, Pllc | |
|
1034 N Main St Brockton MA 02301-1534 | |
| (508) 588-6964 | |
| Not Available |
| Full Name | Medella Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1034 N Main St, Brockton, Massachusetts |
| Authorized Official Name and Position | Sabrina Coombs (CO-OWNER/DENTIST) |
| Authorized Official Contact | 5085886964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medella Dental, Pllc 1034 N Main St Brockton MA 02301-1534 Ph: (508) 588-6964 | Medella Dental, Pllc 1034 N Main St Brockton MA 02301-1534 Ph: (508) 588-6964 |
| NPI Number | 1710573910 |
|---|---|
| Provider Enumeration Date | 12/12/2020 |
| Last Update Date | 12/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710573910 | NPI | - | NPPES |
| 1700282670 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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