MEDICARE: DR. MATTHEW SCOTT WARNER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30022587	OH
2	122300000X	Dentist	4579	SC

General Provider Information

NPI Number	:	1841486206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW SCOTT WARNER DDS

Provider Business Mailing Address
First Line	:	3101 S HIGHWAY 14
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-5950
Country	:	US
Telephone Number	:	864-546-4242
Fax Number	:	864-312-3642

Provider Business Practice Location Address
First Line	:	3101 S HIGHWAY 14
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-5950
Country	:	US
Telephone Number	:	864-546-4242
Fax Number	:	864-312-3642

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	11/18/2020

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