Organization
MIL-LAKE DENTAL
Active
Other names
MIL-LAKE DENTAL AND EYE CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT G. VICTOME DDS (OWNER)
(561) 357-1009
Entity
Organization
Contact information
Practice address
7657 LAKE WORTH RD, LAKE WORTH, FL 33467-2534
(561) 357-1009
(561) 969-7624
Mailing address
6137 LAKE WORTH RD, GREENACRES, FL 33463-3074
(561) 357-1009
(561) 969-7624
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN13708
FL
152W00000X
Optometrist
—
—
156FX1800X
Optician
—
FL
207W00000X
Ophthalmology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
10/20/2016
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