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Dr. John R Provenzano, DDS
Oral and Maxillofacial Surgery (Dentist) in Wichita, Kansas
NPI 1710955430

John R Provenzano is a Oral and Maxillofacial Surgery (Dentist) based in Wichita, KS and is specialized in Oral and Maxillofacial Surgery. John R Provenzano practices in Wichita, KS and has the professional credentials of DDS. The NPI Number for John R Provenzano is 1710955430 and holds a License No. 6557 (Kansas).

The current practice location address for John R Provenzano is 1515 S Clifton Ave, Wichita, KS and can be reached out via phone at 316-681-3757 and via fax at 316-652-0602. You can also correspond with John R Provenzano through the mailing address at 1515 S CLIFTON AVE, WICHITA, KS - 67218-2900 (mailing address contact number: 316-681-3757).

Location: 1515 S Clifton Ave, Wichita, KS, 67218-2900
person
Provider Profile Details
NPI Number
1710955430
Provider Name
John R Provenzano
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1515 S Clifton Ave, Wichita, KS, 67218-2900
Phone Number
316-681-3757
Fax Number
316-652-0602
Provider Enumeration Date
03/09/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1515 S Clifton Ave
City
State
Zip
67218-2900
Phone Number
316-681-3757
Fax Number
316-652-0602
person
Provider Business Mailing Address Details
Address
1515 S Clifton Ave
City
State
Zip
67218-2900
Phone Number
316-681-3757
Fax Number
316-652-0602
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
6557 (Kansas)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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