Individual
GOUA LEO VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
374 SANDRIDGE TRL, SUN PRAIRIE, WI 53590-1316
(479) 357-9260
Mailing address
374 SANDRIDGE TRL, SUN PRAIRIE, WI 53590-1316
(479) 357-9260
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11450-16
WI
172A00000X
Driver
—
—
Other
Enumeration date
09/18/2014
Last updated
05/05/2025
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