Organization
DENNIS R MIRRA, OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS MIRRA OD (OWNER)
(302) 998-3332
Entity
Organization
Contact information
Practice address
2601 ANNAND DR, SUITE 21, WILMINGTON, DE 19808-3719
(302) 998-3332
(302) 998-4828
Mailing address
2601 ANNAND DR, SUITE 21, WILMINGTON, DE 19808-3719
(302) 998-3332
(302) 998-4828
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B86041
DE BLUE CROSS
DE
Enumeration date
08/05/2008
Last updated
03/02/2009
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