Shane C. Blake, D.M.D.
General Dentistry · Coudersport, PA
UnclaimedD.M.D.NPI 1023360609
- Primary taxonomy
- 122300000X
- Enumerated
- 2012-10-08
- Practice location
- Coudersport, PA
- Last NPPES update
- 2012-10-08
State licenses
- PA · Dentist · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.