Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 2901020425 | MI |
NPI | 1093003733 |
---|---|
Provider Name | Dr. Taryn Kay Harreld |
First Address | Norton Shores, MI 49441-6720 |
Second Address | Norton Shores, MI 49441-6720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 06/01/2015 |