Organization
MICHAEL J PERNOUD DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JAMES PERNOUD DDS (PRES/SEC)
16362395959
Entity
Organization
Contact information
Practice address
1015 WASHINGTON SQ STE F, WASHINGTON, MO 63090-5307
(636) 239-5959
Mailing address
1015 WASHINGTON SQ STE F, WASHINGTON, MO 63090-5307
(636) 239-5959
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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