Scott B. Tisdale, DDS

Dentist · St Clair Shores, MI

Individual Active NPI

NPI number 1992879720

Practice location

31549 Harper Ave
St Clair Shores, MI 48082
Phone
(586) 293-1530
Fax
(586) 293-1537

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NPI record

NPI
1992879720
Entity type
Individual (Type 1)
Enumeration date
November 20, 2006
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 2901015365 MI

About Dr. Tisdale

Scott B. Tisdale, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 31549 Harper Ave, St Clair Shores, MI 48082. The NPI number 1992879720 was assigned on November 20, 2006 and the record was last updated on July 8, 2007.

Dr. Tisdale lists a license in the registry: #2901015365 (MI) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Scott B. Tisdale, DDS?

The NPI number is 1992879720.

What is the phone number of Dr. Tisdale?

The phone number listed for the practice location is (586) 293-1530.

Where is Dr. Tisdale located?

31549 Harper Ave, St Clair Shores, MI 48082.

What is the taxonomy code for Dr. Tisdale?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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