Brousell, Gary M

Brousell, Gary M is an individual health care provider with primary practice located at 21 Gilbert Street , Tinton Falls NJ 07724. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Brousell, Gary M can be contacted via phone (732) 747-0993.

Contact Information

Primary practice address
21 Gilbert Street Tinton Falls NJ 07724
Phone: (732) 747-0993
Fax: (732) 747-0961
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 10690 New Jersey
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 22DI0106000 New Jersey

Profile Details

NPI number 1356311302
LBN Legal business name Brousell, Gary M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jun 28th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356311302 NPPES
New Jersey MEDICAID 1863401

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