Provider Demographics
NPI:1760557029
Name:LISCHWE, JANE MARIE (DDS)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:MARIE
Last Name:LISCHWE
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 1:103 NE DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-2037
Mailing Address - Country:US
Mailing Address - Phone:816-524-1337
Mailing Address - Fax:816-525-7640
Practice Address - Street 1:103 NE DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2037
Practice Address - Country:US
Practice Address - Phone:816-524-1337
Practice Address - Fax:816-525-7640
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE0148241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice