Provider Demographics
NPI:1437387305
Name:CLAIBORNE, SCOTT TILSON (DDS, MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:TILSON
Last Name:CLAIBORNE
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 TROOP DR
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4636
Mailing Address - Country:US
Mailing Address - Phone:320-348-7470
Mailing Address - Fax:
Practice Address - Street 1:2380 TROOP DR
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4636
Practice Address - Country:US
Practice Address - Phone:320-348-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT118451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery