Organization
LIVE OAK ORAL SURGERY OF TEXAS PLLC
Active
Organization
LIVE OAK ORAL SURGERY OF TEXAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J GLIDDON DDS (OWNER/ORAL SURGEON)
(580) 699-3131
Entity
Organization
Contact information
Practice address
2708 SOUTHWEST PKWY STE 130, WICHITA FALLS, TX 76308-3735
(580) 699-3131
(580) 699-3151
Mailing address
2708 SOUTHWEST PKWY STE 130, WICHITA FALLS, TX 76308-3735
(580) 699-3131
(580) 699-3151
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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