{
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"FirstLineMailingAddress": "558 CHASE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WATERBURY",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06704-1947",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "203-756-9700",
"FirstLinePracticeLocationAddress": "558 CHASE AVE",
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"PracticeLocationAddressFaxNumber": "203-756-9700",
"EnumerationDate": "03/15/2011",
"LastUpdateDate": "03/15/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PASCAL",
"AuthorizedOfficialFirstName": "CESAR",
"AuthorizedOfficialMiddleName": "AGUSTO",
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"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "203-756-9900",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "009188",
"LicenseNumberStateCode": "CT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}