Organization
DR. GREGORY J. PERNOUD, D.D.S., P.C.
Active
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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