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"FirstLineMailingAddress": "9000 COOMBS FARM DR.",
"SecondLineMailingAddress": "STE. 304",
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"EnumerationDate": "06/06/2018",
"LastUpdateDate": "06/06/2018",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "MINCHAU",
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"AuthorizedOfficialCredential": "D.D.S., M.S.",
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{
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},
{
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}
]
},
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},
{
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}
]
}
}
}