Individual
ALISA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Mailing address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
P71309
NY
Other
Enumeration date
07/06/2009
Last updated
12/14/2012
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