{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "CHARLES R. ARP, DDS, PC",
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"FirstLineMailingAddress": "3280 HOWELL MILL RD NW",
"SecondLineMailingAddress": "SUITE 206",
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30327-4111",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-351-1266",
"MailingAddressFaxNumber": "404-351-1730",
"FirstLinePracticeLocationAddress": "3280 HOWELL MILL RD NW",
"SecondLinePracticeLocationAddress": "SUITE 206",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-351-1266",
"PracticeLocationAddressFaxNumber": "404-351-1730",
"EnumerationDate": "02/21/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARP",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "R.",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "404-351-1266",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "7513",
"LicenseNumberStateCode": "GA",
"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."
}
}
}
}