Individual
GRACE COEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3657
Mailing address
804 PARK AVE APT 304, OMAHA, NE 68105-2170
(641) 831-0257
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11795
OR
Other
Enumeration date
03/13/2023
Last updated
11/26/2025
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