Organization
ADVANCED MAXILLOFACIAL IMAGING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY BROUSELL (OWNER)
(732) 747-0993
Entity
Organization
Contact information
Practice address
21 N GILBERT ST, TINTON FALLS, NJ 07701-4950
(732) 747-0993
(732) 412-9317
Mailing address
21 N GILBERT ST, TINTON FALLS, NJ 07701-4950
(732) 747-0993
(732) 412-9317
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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