Blake Dentistry, Pc is a Dental Clinic in Coudersport, Pennsylvania. It is located at 507 Dwight St, Coudersport, PA and its contact number is 814-274-7262. The authorized person for Blake Dentistry, Pc is Dr. Shane Christopher Blake
who is President of the clinic and their contact number is 814-274-7262. The primary license number for Blake Dentistry, Pc is DS-035521 (General Practice) in Pennsylvania. Blake Dentistry, Pc Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Blake Dentistry, Pc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Shane Christopher Blake
Position:
President
Contact Number:
814-274-7262
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Blake Dentistry, Pc clinic are as mentioned below.
NPI Number:
1962567644
NPI Enumeration Date:
24 Dec, 2006
NPI Last Update On:
22 Aug, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Blake Dentistry, Pc are as mentioned below.
Specialization
License Number
State
Status
General Practice
DS-035521
Pennsylvania
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
0019285420002
Medicaid
Pennsylvania
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Blake Dentistry, Pc 507 Dwight St, Coudersport, Pennsylvania
Zip:
16915-1792
Phone Number:
814-274-7262
Fax Number:
814-274-0879
Patients can reach Blake Dentistry, Pc at 507 Dwight St, Coudersport, Pennsylvania or can call to book an appointment on 814-274-7262. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.