Healthcare Provider Details

I. General information

NPI: 1538845243
Provider Name (Legal Business Name): ABIGAIL JOHNSTONE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N PANSY ST
ISHPEMING MI
49849-3015
US

IV. Provider business mailing address

351 W PARK ST
MARQUETTE MI
49855-3328
US

V. Phone/Fax

Practice location:
  • Phone: 906-485-5575
  • Fax:
Mailing address:
  • Phone: 517-604-1758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901602467
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: