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Individual
DR. CAROLYN MARIE HARRIS
Active
Individual
DR. CAROLYN MARIE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4187
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841871
—
LA
01
—
3724677
EMPLOYER'S STATE ID
LA
01
—
4187
LOUISIANA DENTAL LICENSE
LA
01
—
A2033
BLUE CROSS PROVIDER
LA
Enumeration date
02/16/2007
Last updated
07/09/2007
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