Provider Demographics
NPI:1194036103
Name:FRISICANO, LISA N (DDS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:N
Last Name:FRISICANO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 W HENRIETTA RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1355
Mailing Address - Country:US
Mailing Address - Phone:585-271-4700
Mailing Address - Fax:585-271-4707
Practice Address - Street 1:2024 W HENRIETTA RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1355
Practice Address - Country:US
Practice Address - Phone:585-271-4700
Practice Address - Fax:585-271-4707
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0560331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry