# CCD ARDMORE FAMILY DENTISTRY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Office of Dr. Bellisario
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952872228
- **Authorized official:** MS. BETH WALSH (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (610) 642-7024

## Contact information

- **Practice address:** 636 WYNNEWOOD RD, ARDMORE, PA 19003-2626
- **Practice address phone:** (610) 642-7024
- **Practice address fax:** (610) 642-0658
- **Mailing address:** 636 WYNNEWOOD RD, ARDMORE, PA 19003-2626
- **Mailing address phone:** (610) 642-7024
- **Mailing address fax:** (610) 642-0658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/16/2018
- **Last updated:** 08/19/2020