Individual
DR. MARIANNE LUCILLE COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1221 HAYES AVE, SUITE C, SANDUSKY, OH 44870-3345
(419) 627-8131
(419) 621-1773
Mailing address
3110 COUNTRY CLUB LN, HURON, OH 44839-1080
(419) 625-4191
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30-015952
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0645814
—
OH
Enumeration date
02/07/2007
Last updated
07/08/2007
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