Healthcare Provider Details

I. General information

NPI: 1861971335
Provider Name (Legal Business Name): ISABELLA ANDERSON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 08/26/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USA DENTAL ACTIVITY, HOSPITAL DENTAL CLINIC 1061 HARMON AVE
FT STEWART GA
31314
US

IV. Provider business mailing address

14 BENEDICTINE RETREAT
SAVANNAH GA
31411-1624
US

V. Phone/Fax

Practice location:
  • Phone: 571-802-0377
  • Fax:
Mailing address:
  • Phone: 706-399-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN23759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: