# MICHAEL J PERNOUD DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659538973
- **Authorized official:** DR. MICHAEL JAMES PERNOUD DDS (PRES/SEC)
- **Authorized official phone:** 16362395959

## Contact information

- **Practice address:** 1015 WASHINGTON SQ STE F, WASHINGTON, MO 63090-5307
- **Practice address phone:** (636) 239-5959
- **Mailing address:** 1015 WASHINGTON SQ STE F, WASHINGTON, MO 63090-5307
- **Mailing address phone:** (636) 239-5959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 05/22/2008