| NPI | 1033383047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A GRIMES President 703-222-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401006539) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |