| Mark a Grimes DDS PC | |
|
4437 Brookfield Corporate Drive #107 Chantilly VA 20151 | |
| (703) 222-5400 | |
| (703) 222-0470 |
| Full Name | Mark a Grimes DDS PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4437 Brookfield Corporate Drive, Chantilly, Virginia |
| Authorized Official Name and Position | Mark a Grimes (PRESIDENT) |
| Authorized Official Contact | 7032225400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark a Grimes DDS PC 4437 Brookfield Corporate Drive #107 Chantilly VA 20151 Ph: (703) 222-5400 | Mark a Grimes DDS PC 4437 Brookfield Corporate Drive #107 Chantilly VA 20151 Ph: (703) 222-5400 |
| NPI Number | 1033383047 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033383047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401006539 (Virginia) | Primary |
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