# SOUTHEASTERN-OMS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Oral - Maxillofacial & Facial Cosmetic Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609615871
- **Authorized official:** DR. GREGORY C BESS DMD, MD (ORAL SURGEON/OWNER)
- **Authorized official phone:** (334) 792-2880

## Contact information

- **Practice address:** 216 HEALTHWEST DR, DOTHAN, AL 36303-1942
- **Practice address phone:** (334) 792-2880
- **Practice address fax:** (334) 712-0202
- **Mailing address:** 216 HEALTHWEST DR, DOTHAN, AL 36303-1942
- **Mailing address phone:** (334) 792-2880
- **Mailing address fax:** (334) 712-0202

## Taxonomy

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

## Other

- **Enumeration date:** 05/20/2024
- **Last updated:** 05/20/2024