MICHAEL J. GLIDDON DBA LIVE OAK ORAL SURGERY NPI 1265735724

NPI Information

MICHAEL J. GLIDDON DBA LIVE OAK ORAL SURGERY is an oral and maxillofacial surgery dentist in Lawton, OK. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. MICHAEL J. GLIDDON DBA LIVE OAK ORAL SURGERY NPI is 1265735724. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1415 NW 33RD ST
LAWTON, OK
ZIP 73505-806
Phone: (580) 699-3131
Fax: (580) 699-3151

The provider's authorized official is Vera Ann Wellner .
The authorized official title is Credentialing Rep and has the following contact phone number (405) 848-7974.

The enumeration date for this NPI number is 12/6/2010 and was last updated on 11/13/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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