# MAURINE MACHUGH DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EvergreenPeriodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417935917
- **Authorized official:** MAURINE MACHUGH DDS (DENTIST/OWNER)
- **Authorized official phone:** (425) 820-2414

## Contact information

- **Practice address:** 12911 120TH AVE NE, STE F240, KIRKLAND, WA 98034-3027
- **Practice address phone:** (425) 820-2414
- **Practice address fax:** (425) 814-1757
- **Mailing address:** 12911 120TH AVE NE, STE F240, KIRKLAND, WA 98034-3027
- **Mailing address phone:** (425) 820-2414
- **Mailing address fax:** (425) 814-1757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5017 | WA | Yes |

## Other

- **Enumeration date:** 01/04/2006
- **Last updated:** 01/27/2010