{
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"FirstLineMailingAddress": "PO BOX 158",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ESPANOLA",
"MailingAddressStateName": "NM",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-753-7218",
"MailingAddressFaxNumber": "505-753-5815",
"FirstLinePracticeLocationAddress": "30 NM HIGHWAY 65",
"SecondLinePracticeLocationAddress": "EL CENTRO FAMILY HEALTH LAS VEGAS DENTAL CLINIC",
"PracticeLocationAddressCityName": "LAS VEGAS",
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"PracticeLocationAddressTelephoneNumber": "505-425-6677",
"PracticeLocationAddressFaxNumber": "505-425-9638",
"EnumerationDate": "12/01/2011",
"LastUpdateDate": "12/01/2011",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}