Organization
MARK A GRIMES DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A GRIMES DDS (PRESIDENT)
(703) 222-5400
Entity
Organization
Contact information
Practice address
4437 BROOKFIELD CORPORATE DRIVE, #107, CHANTILLY, VA 20151
(703) 222-5400
(703) 222-0470
Mailing address
4437 BROOKFIELD CORPORATE DRIVE, #107, CHANTILLY, VA 20151
(703) 222-5400
(703) 222-0470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401006539
VA
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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