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Contact Information

GARY M BROUSELL, DDS
21 GILBERT STREET
TINTON FALLS, NJ07724
 Phone: 732-747-0993
 Fax: 732-747-0961
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for GARY M BROUSELL · (Male)

NPI Number 1356311302
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 01/24/2006
Last updated 06/28/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 10690
  • NJ License # 22DI0106000
  • NJ Medicaid 1863401
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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