Individual
DR. DOMINICK R MARTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MARIO CAPECCHI DR, PRIMARY CHILDREN'S MEDICAL CENTER, SALT LAKE CITY, UT 84113-1103
(801) 662-6755
Mailing address
100 MARIO CAPECCHI DR, PRIMARY CHILDREN'S MEDICAL CENTER, SALT LAKE CITY, UT 84113-1103
(801) 662-6755
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036088046
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088046
—
IL
Enumeration date
11/06/2006
Last updated
11/29/2021
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