Organization
SOUTH COAST DENTAL GROUP LLC
Active
Other names
South Coast Family Dentistry, South Coast Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS I HORN (BILLING & CLAIMS MANAGER)
(541) 269-5353
Entity
Organization
Contact information
Practice address
295 S 10TH ST, COOS BAY, OR 97420-4623
(541) 269-5353
(541) 266-0933
Mailing address
295 S 10TH ST, COOS BAY, OR 97420-4623
(541) 269-5353
(541) 266-0933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9399
OR
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/28/2010
Last updated
05/14/2026
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