{
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"OrgName": "DR. GREGORY J. PERNOUD, D.D.S., P.C.",
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"FirstLineMailingAddress": "1204 E HWY 72",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROLLA",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "65401",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-364-1934",
"MailingAddressFaxNumber": "573-364-8110",
"FirstLinePracticeLocationAddress": "112 SOUTH SECOND STREET",
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"PracticeLocationAddressCityName": "FESTUS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "636-937-1515",
"PracticeLocationAddressFaxNumber": "636-937-0790",
"EnumerationDate": "10/12/2006",
"LastUpdateDate": "07/29/2013",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "PERNOUD",
"AuthorizedOfficialFirstName": "GREGORY",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "D.D.S.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "012735",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}