Provider Demographics
NPI:1093893943
Name:MATTHEWS, RALPH E (DMD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:E
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:RALPH
Other - Middle Name:E
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:4105 E NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-292-5125
Mailing Address - Fax:864-292-5124
Practice Address - Street 1:4105 E NORTH STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-292-5125
Practice Address - Fax:864-292-5124
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice