Blake Dentistry, Pc in Coudersport - General Practice
Blake Dentistry, Pc - NPI 1962567644
Blake Dentistry, Pc is a General Practice in Coudersport, Pennsylvania. Blake Dentistry, Pc practices all healthcare services and medical treatments related to General Practice. The NPI Number for Blake Dentistry, Pc is 1962567644. The last update date is 2020-08-22.
Blake Dentistry, Pc's current location address is 507 Dwight St, Coudersport, Pennsylvania. You can contact this provider via phone number 8142747262 and fax number 8142740879. The mailing address for Blake Dentistry, Pc is 507 Dwight St, Coudersport, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Blake Dentistry, Pc |
|---|---|
| Address | 507 Dwight St, Coudersport, Pennsylvania |
| Phone Number | 8142747262 |
| Fax Number | 8142740879 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Blake Christophe Shane |
| Credentials | D.M.D. |
| Telephone Number | 8142747262 |
NPI Number Detail
| NPI Number | 1962567644 |
|---|---|
| Provider Enumeration Date | 2006-12-24 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 507 Dwight St |
|---|---|
| City | Coudersport |
| State | Pennsylvania (PA) |
| Post Code | 169151792 |
| Phone Number | 8142747262 |
| Fax Number | 8142740879 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | DS-035521 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 19285420002 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Blake Dentistry, Pc by the Centers for Medicare & Medicaid Services?
The Blake Dentistry, Pc has been assigned the NPI (National Provider Identifier) 1962567644 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Blake Dentistry, Pc is physically located?
The Blake Dentistry, Pc is physically situated at the following address: 507 Dwight St, Coudersport, PA, 169151792.
What is Blake Dentistry, Pc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Blake Dentistry, Pc's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
When did the Blake Dentistry, Pc receive its 1962567644?
The Blake Dentistry, Pc was issued its 1962567644 on 2006-12-24, which is the date when the organization was assigned this unique identifier.
When was the Blake Dentistry, Pc's information last updated?
The Blake Dentistry, Pc's information was last updated on 2020-08-22.