Provider Demographics
NPI:1073917175
Name:TARYN K. HARRELD, D.D.S., M.S., PC
Entity Type:Organization
Organization Name:TARYN K. HARRELD, D.D.S., M.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARRELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:231-233-1898
Mailing Address - Street 1:3579 HENRY ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-6720
Mailing Address - Country:US
Mailing Address - Phone:231-733-4494
Mailing Address - Fax:
Practice Address - Street 1:3579 HENRY ST
Practice Address - Street 2:SUITE 120
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-6720
Practice Address - Country:US
Practice Address - Phone:231-733-4494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010204251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty