Provider Demographics
NPI:1841309986
Name:WARNOCK, RALPH DOBBIE (DMD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:DOBBIE
Last Name:WARNOCK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 OLD LEXINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-7979
Mailing Address - Country:US
Mailing Address - Phone:803-345-2483
Mailing Address - Fax:803-345-3692
Practice Address - Street 1:740 OLD LEXINGTON HWY
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-7979
Practice Address - Country:US
Practice Address - Phone:803-345-2483
Practice Address - Fax:803-345-3692
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36351223G0001X
GADN0120381223G0001X, 1223P0221X
SCPD05891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZA9582Medicaid
SCZX3635Medicaid