Organization
DR. GREGORY J. PERNOUD, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY J. PERNOUD D.D.S. (PRESIDENT)
(636) 937-1515
Entity
Organization
Contact information
Practice address
112 SOUTH SECOND STREET, FESTUS, MO 63028
(636) 937-1515
(636) 937-0790
Mailing address
1204 E HWY 72, ROLLA, MO 65401
(573) 364-1934
(573) 364-8110
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
012735
MO
Other
Enumeration date
10/12/2006
Last updated
07/29/2013
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