Individual
CONNIE BAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 HORTON ST, LA CROSSE, WI 54601-6372
(608) 788-1090
(608) 787-7665
Mailing address
1212 HORTON ST, LA CROSSE, WI 54601-6372
(608) 788-1090
(608) 787-7665
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001117
WI
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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