{
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"FirstLineMailingAddress": "510 W 32ND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JOPLIN",
"MailingAddressStateName": "MO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "417-781-6700",
"MailingAddressFaxNumber": "417-781-6703",
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"PracticeLocationAddressFaxNumber": "417-781-6703",
"EnumerationDate": "01/10/2013",
"LastUpdateDate": "03/31/2015",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RENGER",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
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"TaxonomyName": "Dentist",
"LicenseNumber": "2002011660",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}