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Individual
JACK FRANCIS COBURN
Active
Individual
JACK FRANCIS COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7163
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D12315
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/19/2020
Last updated
07/22/2026
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