By rent-a-car/private driver, Santo Domingo
We would highly recommend www.prestige-limousine-service.com and www.prestigecarrentals.com. We had a great experience using their airport shuttle service and then when we reached our destination[Casa De Campo] we rented a car from them . Their sales pitch is they will beat any major brand and they did. They also threw in a free gps with the rental car which made our day trips to Santo domingo and Punta Cana a breeze. they have a toll free USA # 1 -866-513-3849
Driving there is very chaotic, and I very strongly discourage you from doing it. Street lights, signs and traffic lanes are not observed by anyone. Many people drive routinely against traffic on one way streets. The buses make very abrupt maneuvers and stops to pick up passengers.
The good thing is that the drivers honk constantly to let other drivers know where they are.