Organization
BROCKPORT DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXIS GHANEM AYOUBI DDS (PRESIDENT)
(585) 503-0713
Entity
Organization
Contact information
Practice address
1000 TRANSIT WAY # 200, BROCKPORT, NY 14420-3008
(585) 957-0981
Mailing address
9 WATERBURY LN, ROCHESTER, NY 14625-1361
(585) 503-0713
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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