Provider Demographics
NPI:1932898327
Name:HARRIS, TAYLOR DAVENPORT (DMD)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:DAVENPORT
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 W ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5709
Mailing Address - Country:US
Mailing Address - Phone:252-355-5252
Mailing Address - Fax:
Practice Address - Street 1:2140 W ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5709
Practice Address - Country:US
Practice Address - Phone:252-355-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC132681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice