Mark a Grimes DDS PC

NPI #1033383047 in Chantilly, Virginia

Provider Information

NPI Number: 1033383047
Entity Type: Organization
Organization Name: Mark a Grimes DDS PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 22, 2008
Last Updated: Apr 22, 2008

Practice Location

Address: 4437 BROOKFIELD CORPORATE DRIVE
Address 2: #107
City: Chantilly
State: Virginia
ZIP Code: 20151
Phone: (703) 222-5400

Authorized Official

Name: DR. MARK A GRIMES, DDS
Title: PRESIDENT
Phone: (703) 222-5400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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