{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "DENTISTRY BY THE DAM PLLC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "1728 TAMARACK AVE NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND RAPIDS",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49504-2849",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "616-648-5608",
"MailingAddressFaxNumber": "616-648-5608",
"FirstLinePracticeLocationAddress": "7166 S CROTON HARDY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEWAYGO",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "231-652-1663",
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"EnumerationDate": "04/30/2025",
"LastUpdateDate": "04/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OSTROWSKI",
"AuthorizedOfficialFirstName": "JOHN",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}