Provider Demographics
NPI:1851019566
Name:WOODS, CODY PHILIP (DMD)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:PHILIP
Last Name:WOODS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIDGEWAY ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1516
Mailing Address - Country:US
Mailing Address - Phone:207-694-5460
Mailing Address - Fax:
Practice Address - Street 1:14 ACCESS HWY STE 4
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-3895
Practice Address - Country:US
Practice Address - Phone:207-492-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN50011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice