Provider Demographics
NPI:1770743346
Name:CRIST, ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:CRIST
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 1:3926 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3614
Mailing Address - Country:US
Mailing Address - Phone:406-761-2151
Mailing Address - Fax:
Practice Address - Street 1:3926 3RD AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-3614
Practice Address - Country:US
Practice Address - Phone:406-761-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist