OrganizationActive
Michael J. Gliddon Dba Live Oak Oral Surgery
NPI 1265735724 · Oral and Maxillofacial Surgery (Dentist) · Lawton, OK
Provider details
- NPI number
- 1265735724
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Vera Ann Wellner, Credentialing Rep(405) 848-7974
- License
- 160 (OK)
Specialties & taxonomies
Dental Providers
Practice location
1415 Nw 33rd St
Lawton, OK 73505-3806
Phone: (580) 699-3131
Fax: (580) 699-3151
Approximate (ZIP-level) locationGet directions
Mailing address
3000 United Founders Blvd
Oklahoma City, OK 73112-3958
Registry dates
- Enumerated
- 2010-12-06
- Last updated
- 2013-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.