Organization
MODERN DENTAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER COUBROUGH DMD, FAGD (OWNER/DENTIST)
(617) 256-7739
Entity
Organization
Contact information
Practice address
1037 BEACON STREET APT 2, BROOKLINE, MA 02446
(617) 738-7210
Mailing address
1037 BEACON STREET, SUITE 2, BROOKLINE, MA 02446
(617) 738-7210
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2023
Last updated
03/27/2023
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