Organization · Type 2 NPI

Michael J. Gliddon dba Live Oak Oral Surgery

Oral and Maxillofacial Surgery (Dentist) · Lawton, OK

NPI number 1265735724 Active

Practice location

1415 NW 33rd St
Lawton, OK 73505-3806

Fax (580) 699-3151

Mailing address

3000 United Founders Blvd, Suite 237
Oklahoma City, OK 73112-3958

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X160 (OK)

Oral and Maxillofacial Surgery (Dentist): 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.

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About NPI 1265735724

Michael J. Gliddon dba Live Oak Oral Surgery's National Provider Identifier is 1265735724, issued on Dec 6, 2010. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Lawton, OK. The record was last updated on Nov 13, 2013.