Provider Demographics
NPI:1154552966
Name:NELSON P. DALY DDS, LLC
Entity type:Organization
Organization Name:NELSON P. DALY DDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:PERRY
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-927-5248
Mailing Address - Street 1:4450 BLUEBONNET BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9648
Mailing Address - Country:US
Mailing Address - Phone:225-927-5248
Mailing Address - Fax:225-927-1788
Practice Address - Street 1:4450 BLUEBONNET BLVD
Practice Address - Street 2:STE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9648
Practice Address - Country:US
Practice Address - Phone:225-927-5248
Practice Address - Fax:225-927-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty