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Individual

DR. MARK WILLIAM WOODDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4600 W 89TH ST, PRAIRIE VILLAGE, KS 66207-2251
(913) 642-8811
(913) 642-8813
Mailing address
4600 W 89TH ST, PRAIRIE VILLAGE, KS 66207-2251
(913) 642-8811
(913) 642-8813

Taxonomy

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

Other

Enumeration date
01/08/2006
Last updated
10/24/2023
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