Provider Demographics
NPI:1679379630
Name:OPEN AND AFFORDABLE DENTAL PLATTE CITY LLC
Entity type:Organization
Organization Name:OPEN AND AFFORDABLE DENTAL PLATTE CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-280-6584
Mailing Address - Street 1:2000 KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7603
Mailing Address - Country:US
Mailing Address - Phone:816-858-2032
Mailing Address - Fax:
Practice Address - Street 1:2000 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7603
Practice Address - Country:US
Practice Address - Phone:816-858-2032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty