Extensions in AdWords – particularly, IMO, Locations, are essential to improving the performance of the campaigns – they give your ads more real estate, they make it easier for mobile users to contact you and they’re free.
Google Places have lately been superseded with Google My Business – it’s okay this is a Google thing, they like to change the name of a product, this then enables the company to have a public Google+ profile.
If you use an AdWords MCC account then you have all your AdWords accounts under one umbrella – this makes it easy to keep your eye on all of your clients’ accounts without endlessly logging in to separate accounts.