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HER AND MAN TOWN DENTAL PLLC
NPI 1275362329
Clinic/Center - Dental in Hermantown, MN

Active since July 29, 2024
4135 RICHARD AVE STE 103, HERMANTOWN, MN 55811(218) 722-2428(218) 722-0142 Get Directions Write a Review

NPPES record last updated: July 29, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Her And Man Town Dental Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HER AND MAN TOWN DENTAL PLLC (NPI 1275362329), doing business as Boulder Trail Dental, is a healthcare organization registered as a dental in Hermantown, Minnesota and active in the NPI registry since July 2024. The organization lists Tracey Makitalo, Insurance Coordinator, as its authorized official.

NPPES Registry Identity

NPI1275362329
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameHER AND MAN TOWN DENTAL PLLC
Location Address4135 RICHARD AVE STE 103Hermantown, MN 55811-2979
Mailing Address4135 Richard Ave Ste 103Hermantown, MN 55811-2979 · (218) 722-2428 · Fax (218) 722-0142
Phone(218) 722-2428
Fax(218) 722-0142
Organization SubpartNo
Authorized OfficialTracey MakitaloInsurance Coordinator · (218) 722-2428
Enumeration DateJuly 29, 2024
NPPES CertifiedJuly 29, 2024
✔ NPI 1275362329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
4135 RICHARD AVE STE 103, Hermantown, MN 55811
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Other Names 1

Doing Business AsBoulder Trail Dental

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MEAGHAN ELIZABETH MORRELL D.D.S
Dentist
4135 RICHARD AVE STE 103
HERMANTOWN, MN 55811
St. Louis County (218) 722-2428

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Her And Man Town Dental PLLC's NPI number?

The NPI number for Her And Man Town Dental PLLC is 1275362329. It was assigned to this organization in the NPPES registry on July 29, 2024. The provider is doing business as Boulder Trail Dental.

Where is Her And Man Town Dental PLLC located?

Her And Man Town Dental PLLC is located at 4135 Richard Ave Ste 103, Hermantown, MN 55811. The listed phone number is (218) 722-2428.

What is Her And Man Town Dental PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Her And Man Town Dental PLLC was last updated on July 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.