Individual
DOMINIC A MIRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3632 10TH LN NW, ROCHESTER, MN 55901-7032
(507) 282-7121
(507) 285-0951
Mailing address
3632 10TH LN NW, ROCHESTER, MN 55901-7032
(507) 282-7121
(507) 285-0951
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
02338
IA
152W00000X
Optometrist
Primary
2746
MN
152W00000X
Optometrist
2755-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
639544900
—
MN
Enumeration date
12/20/2006
Last updated
12/22/2020
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