Provider Demographics
NPI:1093003733
Name:HARRELD, TARYN KAY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TARYN
Middle Name:KAY
Last Name:HARRELD
Suffix:
Gender:F
Credentials:DDS, MS
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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:231-733-4662
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:231-733-4662
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010204251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics