John R Provenzano DDS, PA
John R Provenzano DDS, PA is an Oral and Maxillofacial Surgery (Dentist) in Wichita, Kansas. Licensed in Kansas. Registered with an NPI since 2012.
- Licensed in
- KS
- In the registry since
- 2012
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1515 S Clifton Ave Ste 120Wichita, KS 67218-2951
Phone: (316) 681-3757
Fax: (316) 652-0602
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Oral and Maxillofacial Surgery (Dentist) (primary) | Taxonomy 1223S0112X · Licence 6557 (KS) |
|---|
Record details
| NPI number | 1639449259 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | John Provenzano — Owner · (316) 681-3757 |
| NPI enumerated | January 12, 2012 |
| Last updated in NPPES | February 9, 2012 |
| Mailing address | 1515 S Clifton Ave Ste 120, Wichita, KS 67218-2951 |
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