Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Idaho Dermatologic Surgery & Laser Center PA

Organization Dermatology Physician · NPI 1649478454

Idaho Dermatologic Surgery & Laser Center PA is a Dermatology Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
Specialties on file
4
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1488 N Knights Dr
Boise, ID 83712-6557
Phone: (208) 345-4050
Fax: (208) 327-9524
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence M-7506 (ID)
Dermatology Physician Taxonomy 207N00000X · Licence M-7506 (ID)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence M-7506 (ID)
Medical Specialty Clinic/Center Taxonomy 261QM2500X

Record details

NPI number1649478454
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Teri Cottingham — Owner · (208) 869-2869
NPI enumeratedJuly 3, 2007
Last updated in NPPESFebruary 23, 2024
Certification dateFebruary 23, 2024
Mailing address967 E Parkcenter Blvd # 142, Boise, ID 83706-6721

Other providers in Boise