# MIL-LAKE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MIL-LAKE DENTAL AND EYE CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346798063
- **Authorized official:** DR. ROBERT G. VICTOME DDS (OWNER)
- **Authorized official phone:** (561) 357-1009

## Contact information

- **Practice address:** 7657 LAKE WORTH RD, LAKE WORTH, FL 33467-2534
- **Practice address phone:** (561) 357-1009
- **Practice address fax:** (561) 969-7624
- **Mailing address:** 6137 LAKE WORTH RD, GREENACRES, FL 33463-3074
- **Mailing address phone:** (561) 357-1009
- **Mailing address fax:** (561) 969-7624

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DN13708 | FL | — |
| 152W00000X | Optometrist | — | — | — |
| 156FX1800X | Optician | — | FL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2016
- **Last updated:** 10/20/2016