# GARY BROUSELL, D.D.S.PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760520670
- **Authorized official:** DR. GARY M BROUSELL D.D.S. (PRESIDENT)
- **Authorized official phone:** (732) 747-0993

## Contact information

- **Practice address:** 21 GILBERT ST., TINTON FALL, NJ 07724
- **Practice address phone:** (732) 747-0993
- **Practice address fax:** (732) 747-0961
- **Mailing address:** 31 WARDELL CIR, OCEANPORT, NJ 07757-1610
- **Mailing address phone:** (732) 539-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI10690 | NJ | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 08/22/2020