Individual
DR. KATIE EILEEN JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3968 PINE GROVE AVE, FORT GRATIOT, MI 48059-4218
(810) 984-2208
Mailing address
40793 DELTA DR, NORTHVILLE, MI 48168-3237
(248) 513-0610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.027567
IL
1223G0001X
General Practice Dentistry
Primary
2901020548
MI
Other
Enumeration date
06/29/2007
Last updated
03/27/2012
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