{
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"OrgName": "WM R CHRISTIAN DDS SC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "820 TWO MILE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WISCONSIN RAPIDS",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "54494",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "715-421-2330",
"MailingAddressFaxNumber": "715-421-3425",
"FirstLinePracticeLocationAddress": "820 TWO MILE AVE",
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"PracticeLocationAddressCityName": "WISCONSIN RAPIDS",
"PracticeLocationAddressStateName": "WI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "715-421-2330",
"PracticeLocationAddressFaxNumber": "715-421-3425",
"EnumerationDate": "06/15/2006",
"LastUpdateDate": "06/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHRISTIAN",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PRESIDENT OWNER DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DOCTOR OF DENTISTRY",
"AuthorizedOfficialTelephoneNumber": "715-421-2330",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
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"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}