Most Relevant Information
Provider Data
| NPI Number: | 1013910041 |
| Provider Name: | DOMINICK DETOMMASO D.P.M. |
| Entity Type: | Individual |
| Taxonomy Code: | 213ES0103X |
| Specialty: | Podiatrist |
| License Number: | 07000410A |
Most Important Dates
| Enumeration Date: | 05/23/2005 |
| Last Updated: | 03/22/2016 |
Provider Practice Location
7601 W JEFFERSON BLVD
FORT WAYNE
IN
468044133
Practice Location Phone/Fax
| Phone: | 2604368686 |
| Fax: | 2604368585 |
Provider Mailing Location
7601 W JEFFERSON BLVD
FORT WAYNE
IN
468044133
Provider Mailing Phone/Fax
| Phone: | 2604368686 |
| Fax: | 2604368585 |
Suggested EMR
Podiatry EMR