National Provider Identifier
Alisa Kim, D.M.D.
Alisa Kim, D.M.D. is listed in the NPPES registry with a primary specialty of Dentist in Brockport, NY and a listed phone number of (585) 637-3905.
Profile Overview
- NPI
- 1053540526
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- July 06, 2009
- Last Updated
- December 14, 2012
Practice Location
- 300 West Ave
- Brockport, NY 14420-1118
Phone: (585) 637-3905
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1053540526
- Entity Type
- Individual
- Last Name
- Kim
- First Name
- Alisa
- Credential
- D.M.D.
- Mailing Street Address
- 300 West Ave
- Mailing City
- Brockport
- Mailing State
- NY
- Mailing ZIP Code
- 14420-1118
- Mailing Country
- US
- Mailing Phone
- (585) 637-3905
- Mailing Fax
- (585) 637-4990
- Practice Street Address
- 300 West Ave
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-1118
- Practice Country
- US
- Practice Phone
- (585) 637-3905
- Practice Fax
- (585) 637-4990
- Enumeration Date
- July 06, 2009
- Last Updated
- December 14, 2012
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)