# FIVE STAR FAMILY DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558961540
- **Authorized official:** DR. ROGER BRANDON JR. DDS (OWNER)
- **Authorized official phone:** (210) 455-1110

## Contact information

- **Practice address:** 12991 POTRANCO RD STE 107, SAN ANTONIO, TX 78253-7105
- **Practice address phone:** (210) 455-1110
- **Mailing address:** 12991 POTRANCO RD STE 107, SAN ANTONIO, TX 78253-7105
- **Mailing address phone:** (210) 455-1110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/28/2020
- **Last updated:** 11/06/2020