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NPI Code Detail

MEDICARE: DRS. HERMAN AND MACK P.C.

MEDICARE: DRS. HERMAN AND MACK P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1654ND

General Provider Information

NPI Number : 1588667463
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRS. HERMAN AND MACK P.C.
Provider Business Mailing Address
First Line : 1003 7TH ST NE
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-2719
Country : US
Telephone Number : 701-662-8191
Fax Number : 701-662-5757
Provider Business Practice Location Address
First Line : 1003 7TH ST NE
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-2719
Country : US
Telephone Number : 701-662-8191
Fax Number : 701-662-5757
Authorized Official
Title or Position : PRES
Name : DR. ROLLIN D HERMAN
Credential : DDS
Telephone Number : 701-662-8191
Provider Enumeration Date : 05/24/2005
Last Update Date : 06/27/2008

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