Basic Information
| Provider Information | |||||||||
| NPI: | 1871264861 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAMEWOOD LAUDER | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | EFDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 280 LOMBARD ST # SR | ||||||||
| Address2: | |||||||||
| City: | FALLS CITY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973449708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9717011833 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2400 LANCASTER DR NE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973051297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038132000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2021 | ||||||||
| LastUpdateDate: | 09/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 126800000X | OR | Y | Dental Providers | Dental Assistant |
No ID Information.