Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shane Christopher Blake, DMD

Individual provider Dentist · NPI 1023360609

Dr. Shane Christopher Blake, DMD is a Dentist in Coudersport, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2012
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

507 Dwight St
Coudersport, PA 16915-1792
Phone: (814) 274-7262
Fax: (800) 888-4760
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DS035521 (PA)

Record details

NPI number1023360609
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedOctober 8, 2012
Last updated in NPPESOctober 8, 2012
Mailing address507 Dwight St, Coudersport, PA 16915-1792

Other providers in Coudersport