Provider Demographics
NPI:1497951115
Name:KRISTON, MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KRISTON
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 1:903 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:SUITE #120
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4046
Mailing Address - Country:US
Mailing Address - Phone:925-838-2900
Mailing Address - Fax:925-838-2917
Practice Address - Street 1:903 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE #120
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4046
Practice Address - Country:US
Practice Address - Phone:925-838-2900
Practice Address - Fax:925-838-2917
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA035796122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist