| Live Oak Oral Surgery Of Oklahoma Pllc | |
|
5405 Sw Daun Lawton OK 73505-8508 | |
| (580) 699-3131 | |
| (580) 699-3151 |
| Full Name | Live Oak Oral Surgery Of Oklahoma Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 5405 Sw Daun, Lawton, Oklahoma |
| Authorized Official Name and Position | Michael J Gliddon (OWNER) |
| Authorized Official Contact | 5806993131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Oral Surgery Of Oklahoma Pllc Po Box 258841 Oklahoma City OK 73125-8841 Ph: (580) 699-3131 | Live Oak Oral Surgery Of Oklahoma Pllc 5405 Sw Daun Lawton OK 73505-8508 Ph: (580) 699-3131 |
| NPI Number | 1053986935 |
|---|---|
| Provider Enumeration Date | 05/24/2021 |
| Last Update Date | 05/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053986935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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