| Live Oak Oral Surgery Of Texas Pllc | |
|
2708 Southwest Pkwy Ste 130 Wichita Falls TX 76308-3735 | |
| (580) 699-3131 | |
| (580) 699-3151 |
| Full Name | Live Oak Oral Surgery Of Texas Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2708 Southwest Pkwy Ste 130, Wichita Falls, Texas |
| Authorized Official Name and Position | Michael J Gliddon (OWNER/ORAL SURGEON) |
| 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 Texas Pllc 2708 Southwest Pkwy Ste 130 Wichita Falls TX 76308-3735 Ph: (580) 699-3131 | Live Oak Oral Surgery Of Texas Pllc 2708 Southwest Pkwy Ste 130 Wichita Falls TX 76308-3735 Ph: (580) 699-3131 |
| NPI Number | 1649834680 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 04/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649834680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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