Mark Paul Jones, DDS
289 Main Street Salem, NH 03079
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $89 | 0% | $89 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $158 | 0% | $158 | Medium |
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $32 | 0% | $32 | Medium |
| X-Ray Dental - Two images - bitewings | $47 | 0% | $47 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $37 | 0% | $37 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $205 | 0% | $205 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $184 | 0% | $184 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $205 | 0% | $205 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $184 | 0% | $184 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $205 | 0% | $205 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $368 | 0% | $368 | Medium |