Provider Demographics
NPI:1295575140
Name:SEAN M DALY DDS PC
Entity type:Organization
Organization Name:SEAN M DALY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-463-6664
Mailing Address - Street 1:2217 W 12TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3660
Mailing Address - Country:US
Mailing Address - Phone:402-463-6664
Mailing Address - Fax:402-463-6900
Practice Address - Street 1:2217 W 12TH ST STE 1
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3660
Practice Address - Country:US
Practice Address - Phone:402-463-6664
Practice Address - Fax:402-463-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental