Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SHANE CHRISTOPHER BLAKE, D.M.D.
Active Sole ProprietorDentist · COUDERSPORT, PA
Registration Details
- NPI Number
- 1023360609
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 8, 2012 (13.586040796168 yrs)
- Last Updated
- Oct 8, 2012
- License
-
DS035521 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
507 DWIGHT STCOUDERSPORT, PA, 169151792Browse PA providers · Browse ZIP 16915
- Phone
- 8142747262
- Fax
- 8008884760
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in COUDERSPORT, PA
| Name | Credential | NPI |
|---|---|---|
| VICTOR DOUGLAS BROWN | DMD | 1245294875 |
| DR. PETER C RYAN | DMD | 1568569168 |
| DR. LARISSA ANN DELO | D.D.S. | 1114081874 |
| DR. NINA LELIC MILLER | DMD | 1205498458 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.