Individual
DR. RICHARD M. MIRRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
24 MAPLE AVE, SUITE 6, ROCKVILLE CENTRE, NY 11570
(516) 766-0580
(516) 766-6755
Mailing address
24 MAPLE AVE, SUITE 6, ROCKVILLE CENTRE, NY 11570
(516) 766-0580
(516) 766-6755
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
049891
NY
Other
Enumeration date
09/14/2006
Last updated
09/07/2011
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