{
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"FirstLineMailingAddress": "405 MAIN ST",
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"MailingAddressCityName": "GORHAM",
"MailingAddressStateName": "ME",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "207-839-6266",
"MailingAddressFaxNumber": "207-839-7019",
"FirstLinePracticeLocationAddress": "405 MAIN ST",
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"PracticeLocationAddressCityName": "GORHAM",
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"PracticeLocationAddressFaxNumber": "207-839-7019",
"EnumerationDate": "06/20/2016",
"LastUpdateDate": "06/20/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCBRIDE",
"AuthorizedOfficialFirstName": "ANDREA",
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"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "207-839-6266",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "DEN4035",
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"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."
}
}
}
}