Daniel H De Tolla, MD DDS
200 Griffin Road, Suite 8 Portsmouth, NH 03801
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Dental Exam - Comprehensive | $139 | 0% | $139 | Medium |
| Dental Exam - Periodic, Established Patient | $107 | 0% | $107 | Medium |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $113 | 0% | $113 | Medium |
| Tooth Extraction - Elevation and/or Forceps Removal | $218 | 0% | $218 | Medium |
| X-Ray - Whole Mouth from Outside Mouth | $150 | 0% | $150 | Medium |
