| NPI | 1649834680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J GLIDDON Owner/Oral Surgeon 580-699-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |