JOHN R PROVENZANO

WICHITA, KS
NPI1710955430
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: KS  6557)
Enumeration Date2006-03-09
Last Update Date2011-10-11
Business Address
Dr. JOHN R PROVENZANO dds
1515 S CLIFTON AVE SUITE 120
WICHITA, KS 67218-2900
Phone number: 316-681-3757
Mailing Address
Dr. JOHN R PROVENZANO dds
1515 S CLIFTON AVE SUITE 120
WICHITA, KS 67218-2900
Phone number: 316-681-3757
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