Healthcare Provider Details

I. General information

NPI: 1083747943
Provider Name (Legal Business Name): STEPHEN M WARNICK II DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MASSINGILL RD
PICKENS SC
29671
US

IV. Provider business mailing address

101 PONDSTONE DR
EASLEY SC
29642-7879
US

V. Phone/Fax

Practice location:
  • Phone: 864-878-2428
  • Fax: 864-878-3080
Mailing address:
  • Phone: 864-878-2428
  • Fax: 864-878-3080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number4101
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: