Gliddon, Michael John
Gliddon, Michael John is an sole proprietor health care provider with primary practice located at 3617 W. Gore Blvd. Suite B, Lawton OK 73505-6373. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gliddon, Michael John can be contacted via phone (580) 357-0888.Contact Information
Primary practice address
3617 W. Gore Blvd. Suite B
Lawton OK 73505-6373
Phone: (580) 357-0888
Fax: (580) 248-1860
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 19422 | Texas |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 160 | Oklahoma |
Profile Details
| NPI number | 1285604553 |
|---|---|
| LBN Legal business name | Gliddon, Michael John |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Mar 5th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285604553 | NPPES |
| Oklahoma | MEDICAID | 200345180A |
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