{
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"FirstLineMailingAddress": "19 SE 5TH AVE",
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"MailingAddressCityName": "PERRYTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79070-3111",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "806-435-5335",
"MailingAddressFaxNumber": "806-435-2811",
"FirstLinePracticeLocationAddress": "19 SE 5TH AVE",
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"PracticeLocationAddressTelephoneNumber": "806-435-5335",
"PracticeLocationAddressFaxNumber": "806-435-2811",
"EnumerationDate": "10/04/2017",
"LastUpdateDate": "10/04/2017",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALLEN",
"AuthorizedOfficialFirstName": "ZOEL",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
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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."
}
}
}
}