Individual
DR. PHILIP JORDAN LA LANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1880 LANCASTER DR NE STE 104, SALEM, OR 97305
(503) 587-9949
Mailing address
1880 LANCASTER DR NE STE 104, SALEM, OR 97305-1040
(503) 587-9949
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10904
OR
Other
Enumeration date
09/11/2018
Last updated
09/25/2018
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