Provider Demographics
NPI:1861971335
Name:ANDERSON, ISABELLA (DMD)
Entity type:Individual
Prefix:DR
First Name:ISABELLA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BENEDICTINE RETREAT
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-1624
Mailing Address - Country:US
Mailing Address - Phone:706-399-3633
Mailing Address - Fax:
Practice Address - Street 1:USA DENTAL ACTIVITY, HOSPITAL DENTAL CLINIC
Practice Address - Street 2:1061 HARMON AVE
Practice Address - City:FT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314
Practice Address - Country:US
Practice Address - Phone:571-802-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN237591223S0112X, 1223S0112X
FL23759122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist