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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