JOHN R PROVENZANO DDS,PA
Organization (NPI-2)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1639449259- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1515 S CLIFTON AVE STE 120, WICHITA, KS, 672182951
- Phone
- (316) 681-3757
- Fax
- (316) 652-0602
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
Primary License: KS #6557