Provider Demographics
NPI:1285939017
Name:WARD, JARED ALAN (DMD, MS)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:ALAN
Last Name:WARD
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 TRADEWIND CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3503
Mailing Address - Country:US
Mailing Address - Phone:970-402-3785
Mailing Address - Fax:
Practice Address - Street 1:2720 COUNCIL TREE AVE
Practice Address - Street 2:SUITE 266
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6306
Practice Address - Country:US
Practice Address - Phone:970-402-3785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics