Healthcare Provider Details

I. General information

NPI: 1497641963
Provider Name (Legal Business Name): MICHAEL C. KRETCHMER DDS, MS, PA I
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10931 STRICKLAND RD STE 101
RALEIGH NC
27615-2085
US

IV. Provider business mailing address

10931 STRICKLAND RD STE 101
RALEIGH NC
27615-2085
US

V. Phone/Fax

Practice location:
  • Phone: 919-844-7140
  • Fax:
Mailing address:
  • Phone: 919-844-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL KRETCHMER
Title or Position: PARTNER
Credential: DDS
Phone: 919-844-7140