{
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"OrgName": "STEPHEN F. WOOD, D.D.S., PA",
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"FirstLineMailingAddress": "4402 VANCE JACKSON RD",
"SecondLineMailingAddress": "SUITE 235",
"MailingAddressCityName": "SAN ANTONIO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78230-5336",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-558-3133",
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"FirstLinePracticeLocationAddress": "4402 VANCE JACKSON RD",
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"PracticeLocationAddressCityName": "SAN ANTONIO",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "210-558-3133",
"PracticeLocationAddressFaxNumber": "210-308-9062",
"EnumerationDate": "04/10/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PIERCE",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "210-558-3133",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "12524",
"LicenseNumberStateCode": "TX",
"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."
}
}
}
}