{
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"FirstLineMailingAddress": "1945 N FINE AVE",
"SecondLineMailingAddress": "SUITE 116",
"MailingAddressCityName": "FRESNO",
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"MailingAddressPostalCode": "93727-1528",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-457-5271",
"MailingAddressFaxNumber": "559-457-5894",
"FirstLinePracticeLocationAddress": "302 FRESNO ST",
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"EnumerationDate": "07/05/2007",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "MADRIGAL",
"AuthorizedOfficialFirstName": "MICHAEL",
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"Taxonomies": {
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"TaxonomyName": "General Practice Dentistry",
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}
},
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}
}
}
}