VIRGIL ULLOM

LAKE WALES, FL
NPI1710021415
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: FL  DN9072)
Enumeration Date2007-02-16
Last Update Date2007-07-09
Business Address
Dr. VIRGIL ULLOM D.D.S.
1 SCENIC CENTRAL STE 107
LAKE WALES, FL 33853-6107
Phone number: 863-678-1939
Mailing Address
Dr. VIRGIL ULLOM D.D.S.
245 BABSON DR
BABSON PARK, FL 33827-9516
Phone number: 863-638-2228