{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "NATHAN L. AHLERS, D.D.S., P.C.",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "227 W LYNDALE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HELENA",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59601-2825",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-443-6464",
"MailingAddressFaxNumber": "406-443-0465",
"FirstLinePracticeLocationAddress": "227 W LYNDALE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HELENA",
"PracticeLocationAddressStateName": "MT",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-443-6464",
"PracticeLocationAddressFaxNumber": "406-443-0465",
"EnumerationDate": "01/25/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AHLERS",
"AuthorizedOfficialFirstName": "NATHAN",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "406-443-6464",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "2084",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}