# DR. MARK WILLIAM WOODDY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1932187093
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2000150743 | MO | — |
| 122300000X | Dentist | 410236 | VA | — |
| 122300000X | Dentist | 60010 | KS | — |
| 1223G0001X | General Practice Dentistry | 60010 | KS | Yes |

## Other

- **Enumeration date:** 01/08/2006
- **Last updated:** 10/24/2023