Provider Demographics
NPI:1568470557
Name:JOHNSTON, PAUL CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 HIGHWAY 55
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-3734
Mailing Address - Country:US
Mailing Address - Phone:651-437-5340
Mailing Address - Fax:651-437-3780
Practice Address - Street 1:925 HIGHWAY 55
Practice Address - Street 2:SUITE 104
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-3734
Practice Address - Country:US
Practice Address - Phone:651-437-5340
Practice Address - Fax:651-437-3780
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist