Organization
SALLY B. DALY DDS LLC
Active
Other names
Fleur de Lis Mobile Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY BOWIE DALY DDS (OWNER)
(225) 767-5343
Entity
Organization
Contact information
Practice address
10713 N OAK HILLS PKWY, SUITE B, BATON ROUGE, LA 70810-2967
(225) 767-5343
Mailing address
PO BOX 82380, BATON ROUGE, LA 70884-2380
(225) 767-5343
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4860
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1848603
—
LA
01
—
2959
MCNA
LA
Enumeration date
09/28/2015
Last updated
09/28/2015
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