OrganizationActive
Prison Rehabilitative Industries & Diversified Enterprises
NPI 1275834129 · Dental Laboratory · St. Petersburg, FL
Provider details
- NPI number
- 1275834129
- Entity type
- Organization
- Primary specialty
- Dental LaboratoryLaboratories
- Authorized official
- Denise Kiminki, Assistant Secretary to the Board
Practice location
12425 28th St. N.
Suite 300
St. Petersburg, FL 33716
Phone: (727) 556-3300
Fax: (727) 570-3449
Mailing address
12425 28th St N
St Petersburg, FL 33716-1844
Registry dates
- Enumerated
- 2010-11-09
- Last updated
- 2010-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.