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 |
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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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