Provider Demographics
NPI:1336507797
Name:WARNOCK, MATTHEW EDWARD (DDS)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:EDWARD
Last Name:WARNOCK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16985 MONTEREY RD.
Mailing Address - Street 2:300A
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-9677
Mailing Address - Country:US
Mailing Address - Phone:408-778-8555
Mailing Address - Fax:408-778-8558
Practice Address - Street 1:16985 MONTEREY RD
Practice Address - Street 2:300A
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5116
Practice Address - Country:US
Practice Address - Phone:408-778-8555
Practice Address - Fax:408-778-8558
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1008431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice