{
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"EIN": null,
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"OrgName": "GREATER CHARLOTTE ORAL & FACIAL SURGERY",
"LastName": null,
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"FirstLineMailingAddress": "10935 WINDS CROSSING DR",
"SecondLineMailingAddress": "SUITE 400",
"MailingAddressCityName": "CHARLOTTE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28273-2402",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "980-939-1400",
"MailingAddressFaxNumber": "980-939-1460",
"FirstLinePracticeLocationAddress": "10935 WINDS CROSSING DR",
"SecondLinePracticeLocationAddress": "SUITE 400",
"PracticeLocationAddressCityName": "CHARLOTTE",
"PracticeLocationAddressStateName": "NC",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "980-939-1400",
"PracticeLocationAddressFaxNumber": "980-939-1460",
"EnumerationDate": "05/02/2013",
"LastUpdateDate": "10/10/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARASHI",
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"AuthorizedOfficialCredential": "MD,DDS",
"AuthorizedOfficialTelephoneNumber": "980-939-1400",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "01124",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}