Provider Demographics
NPI:1578581625
Name:WREN, JANE ALLISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ALLISON
Last Name:WREN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 LEVERETT LN
Mailing Address - Street 2:.
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3722
Mailing Address - Country:US
Mailing Address - Phone:440-646-1983
Mailing Address - Fax:216-421-3043
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:160-W
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-421-3043
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300175751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice