{
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"FirstLineMailingAddress": "2102 PORT TOWNSEND CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBIA",
"MailingAddressStateName": "MO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-424-2067",
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"FirstLinePracticeLocationAddress": "3621 DISCOVERY PARKWAY",
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"EnumerationDate": "08/10/2023",
"LastUpdateDate": "08/10/2023",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LISENBY",
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"Taxonomies": {
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"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}