GOUA LEO VANG

SUN PRAIRIE, WI
NPI1114329448
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: WI  11450-16)
Additional Taxonomies172A00000X Driver
Enumeration Date2014-09-18
Last Update Date2025-05-05
Business Address
GOUA LEO VANG RDH
374 SANDRIDGE TRL
SUN PRAIRIE, WI 53590-1316
Phone number: 479-357-9260
Mailing Address
GOUA LEO VANG RDH
374 SANDRIDGE TRL
SUN PRAIRIE, WI 53590-1316
Phone number: 479-357-9260
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