Provider Demographics
NPI:1013135748
Name:KIRSCHENBAUM, ALISON NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:NICOLE
Last Name:KIRSCHENBAUM
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 1:1755 STANLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1953
Mailing Address - Country:US
Mailing Address - Phone:248-644-1755
Mailing Address - Fax:
Practice Address - Street 1:940 W AVON RD
Practice Address - Street 2:SUITE 12
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2760
Practice Address - Country:US
Practice Address - Phone:248-652-7172
Practice Address - Fax:248-652-0748
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIA29010189231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice