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Organization
COBURN DENTAL OFFICE LLC
Active
Organization
COBURN DENTAL OFFICE LLC
Active
Other names
Sandcreek Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD RYAN COBURN D.M.D (OWNER)
(406) 377-8265
Entity
Organization
Contact information
Practice address
116 N MEADE AVE, GLENDIVE, MT 59330-1604
(406) 377-8265
(406) 377-8267
Mailing address
116 N MEADE AVE, GLENDIVE, MT 59330-1604
(406) 377-8265
(406) 377-8267
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2288
MT
Other
Enumeration date
08/27/2012
Last updated
11/23/2015
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