Organization
MARCOS GRANDE DDS PLLC
Active
Other names
Express Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS GRANDE DDS (DENTIST)
(703) 471-7164
Entity
Organization
Contact information
Practice address
108 ELDEN ST, 10, HERNDON, VA 20170-4828
(703) 471-7164
(703) 471-1801
Mailing address
108 ELDEN ST, 10, HERNDON, VA 20170-4828
(703) 471-7164
(703) 471-1801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411982
VA
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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