Provider Demographics
NPI:1871264861
Name:DAMEWOOD LAUDER, BRITTANY E (EFDA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:E
Last Name:DAMEWOOD LAUDER
Suffix:
Gender:F
Credentials:EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 LOMBARD ST # SR
Mailing Address - Street 2:
Mailing Address - City:FALLS CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97344-9708
Mailing Address - Country:US
Mailing Address - Phone:971-701-1833
Mailing Address - Fax:
Practice Address - Street 1:2400 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1297
Practice Address - Country:US
Practice Address - Phone:503-813-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant