Healthcare Provider Details

I. General information

NPI: 1689358673
Provider Name (Legal Business Name): REESE THOMAS GEBERS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5609 S 27TH ST
LINCOLN NE
68512-1602
US

IV. Provider business mailing address

5609 S 27TH ST
LINCOLN NE
68512-1602
US

V. Phone/Fax

Practice location:
  • Phone: 402-420-0999
  • Fax:
Mailing address:
  • Phone: 402-420-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7916
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: