Healthcare Provider Details

I. General information

NPI: 1518841998
Provider Name (Legal Business Name): MICHAEL REZICH D.D.S. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BETZ RD
BELLEVUE NE
68005-3059
US

IV. Provider business mailing address

1201 BETZ RD
BELLEVUE NE
68005-3059
US

V. Phone/Fax

Practice location:
  • Phone: 402-291-3721
  • Fax: 402-291-7566
Mailing address:
  • Phone: 402-291-3721
  • Fax: 402-291-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL TOBIN REZICH
Title or Position: OWNER/PRESIDENT
Credential: DDS
Phone: 402-291-3721