Individual
JOHN A BENUSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 N CARRIAGE PKWY, SUITE #60, WICHITA, KS 67208-4507
(316) 686-2721
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 546-3333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60424
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116988
BCBS OF KS
KS
Enumeration date
09/27/2006
Last updated
07/09/2007
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