# MELLISSA ILGEN, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** APPLETREE COVE DENTAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386241636
- **Authorized official:** DR. MELLISSA ILGEN DDS (DENTIST)
- **Authorized official phone:** (206) 900-1417

## Contact information

- **Practice address:** 26114 ILLINOIS AVE NE, KINGSTON, WA 98346-7674
- **Practice address phone:** (360) 297-3392
- **Mailing address:** PO BOX 149, KINGSTON, WA 98346-0149
- **Mailing address phone:** (360) 297-3392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2020
- **Last updated:** 10/10/2020