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4450 Bluebonnet Blvd Ste B Baton Rouge LA 70809-9648 | |
| (225) 927-5248 | |
| (225) 927-1788 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4450 Bluebonnet Blvd, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Nelson Perry Daly (OWNER) |
| Authorized Official Contact | 2259275248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4450 Bluebonnet Blvd Ste B Baton Rouge LA 70809-9648 Ph: (225) 927-5248 | 4450 Bluebonnet Blvd Ste B Baton Rouge LA 70809-9648 Ph: (225) 927-5248 |
| NPI Number | 1154552966 |
|---|---|
| Provider Enumeration Date | 07/29/2009 |
| Last Update Date | 07/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154552966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4689 (Louisiana) | Primary |
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