Individual
DR. MICHAEL JOHN GLIDDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3617 W. GORE BLVD., SUITE B, LAWTON, OK 73505-6373
(580) 357-0888
(580) 248-1860
Mailing address
3617 W. GORE BLVD, SUITE B, LAWTON, OK 73505-6373
(580) 357-0888
(580) 248-1860
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
160
OK
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
19422
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200345180A
—
OK
Enumeration date
01/26/2006
Last updated
03/05/2012
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