1. Home
  2. Directory
  3. Minnesota
  4. Hermantown
  5. Clinic Center
  6. NPI Profile

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: July 19, 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
Open in Google Maps ↗

Other Names 1

Doing Business AsBoulder Trail Dental

Reviews for HER AND MAN TOWN DENTAL PLLC

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

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

What is HER AND MAN TOWN DENTAL PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1275362329, enumerated as an "organization" on July 29, 2024.

Where is the provider located?

The provider is located at 4135 RICHARD AVE STE 103 HERMANTOWN, MN 55811 and the phone number is (218) 722-2428.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.