DR. Scott B Tisdale, DDS

NPI #1992879720 in St Clair Shores, Michigan

Provider Information

NPI Number: 1992879720
Entity Type: Individual
Name: DR. Scott B Tisdale, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Nov 20, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 31549 HARPER AVE
City: St Clair Shores
State: Michigan
ZIP Code: 48082
Phone: (586) 293-1530

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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