Cedric H Dustin, DDS
47 Main Street Pittsfield, NH 03263
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $86 | N/A | $86 |
| Dental Cleaning - Child | $67 | N/A | $67 |
| Dental Exam - Periodic, Established Patient | $42 | N/A | $42 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $231 | N/A | $231 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $336 | N/A | $336 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $284 | N/A | $284 |
| Dental Filling - White (Resin): One Surface, Anterior | $131 | N/A | $131 |
| Dental Filling - White (Resin): One Surface, Posterior | $294 | N/A | $294 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $368 | N/A | $368 |
| Flouride - Topical Varnish Application | $32 | N/A | $32 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $105 | N/A | $105 |
| Sealant - Placed on Tooth Surface to Prevent Decay | $42 | N/A | $42 |
| X-Ray - Complete Intraoral Series | $210 | N/A | $210 |
| X-Ray - Intraoral, Periapical Radiographic Image | $21 | N/A | $21 |
| X-Ray - Two Images, Bitewings | $74 | N/A | $74 |