Provider Demographics
NPI:1073891644
Name:KMB ASSOCIATES PLLC
Entity Type:Organization
Organization Name:KMB ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:MALESPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-448-3599
Mailing Address - Street 1:938 ALDINE BENDER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032
Mailing Address - Country:US
Mailing Address - Phone:281-449-1053
Mailing Address - Fax:281-449-1821
Practice Address - Street 1:938 ALDINE BENDER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-2802
Practice Address - Country:US
Practice Address - Phone:281-449-1053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty