GDN's Emerging Dental Groups to Watch in 2018

Group dentistry is constantly changing and evolving. There isn’t just one path to success. While private equity and the dental industry may be focused on large DSOs, smaller, but equally important emerging groups are quietly changing the landscape of dentistry. Here is Group Dentistry Now’s list of nine emerging dental groups to watch in 2018 (in alphabetical order)*:

7to7 Dental & Orthodontics, founded by Justin Coke, started in 2008. They have five offices in greater San Antonio. The group’s mission is to break down traditional barriers to entry so that patients may regularly visit the dentist without losing time from work or school. This is accomplished with daily extended hours seven days a week. So far their strategy has been exclusively de novo. However, as growth expectations increase, a hybrid strategy of both de novo and acquisitions will be utilized.

7to7 Dental & Orthodontics’ long term growth plan is to continue annual revenue growth organically through innovation, commitment to continuing education for every team member, and to grow their footprint in San Antonio and surrounding markets. Their goal for 2018 is to add two new state-of-the-art facilities, adding 20 additional chairs. Their revenue is currently $20 million and EBITDA is $4 million. Their growth strategy is focused on total revenue rather than a specific number of locations. Projected growth trajectory will land them at their annual $100 million goal within 10 years.

Locally owned and operated practices allow their dentists to maintain clinical autonomy while working in a collaborative group setting. Preferring to promote from within, all clinical team members and administrative staff are encouraged to increase their skill set to create their career success within the group. 7to7 Dental & Orthodontics gives back to the community through Dental Hope, school supply drives, and toy donations.

Key executives in group:
Justin Coke: Founder and Chief Executive Officer
Tiffany Winburn: Partner and Chief Clinical Officer

Affiliated Dental Partners is the youngest group on the list. Starting in February 2018, and founded by Dr. Alex Giannini, the group will be launching with 18 practices and anticipate 50 by the end of the year. Locations will be in Florida, Virginia and South Carolina. The group is a doctor owned, doctor lead, and doctor controlled DSO. Their strategy is affiliation for entrepreneurial doctors who have the desire, passion, and motivation to grow to the next level.

Their goal for 2018 is to grow exponentially from zero to $50 Million in revenue. Their long-term growth plan is to grow entrepreneurial doctor relationships opportunistically on a national basis.

What is unique about Affiliated Dental Partners is that they are offering dentists the ability to affiliate on a joint venture basis, whereby the doctor founder accesses the capital, management resources and experience to grow the organization and offices both internally and via acquisition. This affords the JV doctor the opportunity to grow their own group/DSO under Affiliated Dental Partners’ umbrella without them having to seek capital and the infrastructure which may stifle all entrepreneurial doctors in one way or the other in their professional careers.

Between Dr. Giannini and Mr. Waltzer, their combined experience of having founded, worked, and exited successfully from seven DSOs, gives doctors joining Affiliated Dental Partners an edge. Partnered dentists can monetize some of their equity and then reinvest in themselves and the group. They are a non-branded, patient centered, and doctor lead organization focused on entrepreneurial dentists.

A key success is that they have been in the Dental Group/DSO business since in 1989. The executives have a combined experience of over 40 years.

Key executives in group: David Waltzer and Dr. Alex Giannini

Chicagoland Smile Group (CSG) has 13 locations in the city of Chicago and its suburbs. Founded by Roshan Parikh, DDS, MBA in 2013, the group’s mission is to consistently deliver stronger and healthier smiles to patients, team members, and partners alike.

Their strategy is affiliation and they plan to expand into more Chicago area communities and neighborhoods in 2018. CSG’s support model and dedication to the Chicago area enables them to help doctors and specialists build their practices and develop long-term relationships with their patients. By focusing on a single market area, they position themselves to provide essential practice support with a centrally-located support center and team, respond to partner dentists’ needs, and promote clinical collaboration and collegiality across the network.

Over the past year, the CSG clinic count has doubled, including the additions of two very large oral health centers in downtown Chicago. Also, about 100 employees were added to the CSG network. Recently the Chicagoland Smile Group support center office relocated to a larger space, with the addition of key roles including: Director of Marketing, Regional Operations Managers, Integrations Manager, and Director of Human Resources. CSG’s goals for 2018 include reaching more patients in new communities through additional affiliations at a rate similar to that of our 2017 growth.

With a philosophy based on collegiality and collaboration, CSG says that happy employees will lead to happy patients. Dentists are encouraged to meet individual clinical goals through a continuing education program in partnership with the Dawson Academy and The Pacific Aesthetic Continuum.

A key success for CSG was in 2017 when they established a Clinical Quality Committee, a group of peer clinicians to effectively evaluate and support key clinical initiatives and promote clinical excellence throughout their practice network.

CSG’s dentists and staff regularly exhibit their sense of community by spending time with team members across the network outside of the office, holding holiday celebrations, team meals, and sports outings. They give back to practice communities and recently held their second free dental day, Mission: Veteran Smiles. Chicagoland Smile Group employees provided dental care to veterans and their families as a gesture of gratitude for their service and sacrifice. They hope to treat even more veterans and military families next year!

CSG Seller-Dentists at Mission: Veteran Smiles

Key executives in group:
Roger Murray, CEO
Dr. Roshan Parikh, Founder & President
Dr. Viren Patel, VP of Clinical Development
Andy Colmone, CFO; Darcie Surinak, VP of Operations
Fletcher Boyle, VP of Corporate Development & Strategy
Dr. Daniel Dohnalek, Director of Corporate Development
Molly McFarland, Director of Marketing & Patient Experience

DecisionOne Dental Partners, which started in 2011, now has 22 locations in the Chicagoland area. All 22 locations are affiliated practices. The group, founded by Drs. AJ and Michael Acierno, is on a mission to try to change the way dentistry is done to improve lives. They want to be a group that people WANT to work for, and not HAVE to work for. In order to accomplish this, the focus is on their employees. To attract dentists, Decision One focuses on salary, bonus program, and benefits. To retain staff, they focus on education and training. This training goes beyond clinical skills and includes leadership, customer service, communication, etc. They want to train their people to not be just better at their job, but to be better people. Their philosophy is that when people are treated right, love their job and where they work, it will reflect in their service and improve patient experience.

Their key success is impressive doctor retention. Turnover of both team members and doctors is one of the biggest issues that group practices face. Decision One believes that a big key to an excellent patient experience is consistency, and nothing provides that consistency quite like seeing familiar faces. Of the 32 doctors that they currently employee, the doctor retention rate is 97% since they started the group. They want dentists to stay for their entire career.

Their goals for 2018 are adding 8-10 acquisition offices in the Chicagoland area, growth into another state, and expansion of the clinical offerings in current offices.

Key executives in group:
AJ Acierno DDS, Chief Executive Officer
Michael Acierno DDS, Chief Medical Officer
Michael Jettner, Chief Admin. Officer
Alan Acierno, Chief Financial Officer
Michael Olson, Director of Acquisitions
Jason Genta DDS, VP of Clinical Affairs

Dentistry Making a Difference (DMD), founded in 2016 by Tanner Applegate and Dr. Benjamin Bassett, currently has five locations in the greater Denver area, all through affiliation. They have a unique model DSO because the entire purpose of their model is the way they measure success: the positive impact they create on people. How much good they are doing is how they know if they are completing their mission and are successful as a DSO. Their priority is not the bottom line net income numbers. They would like to see more of this philosophy in the business world at large, but specifically in the DSO world.

Considering themselves the “Toms Shoes” of dentistry, DMD donates 10% of profits, starts their days with free patients, and places an emphasis on caring. They are fanatical about creating a culture where DSOs are known for the good that they do, and not the drive for profits. For example, with their 2017 third quarter theme of profit donations for their local communities, they were able to donate over $17,000 in one quarter. Team members were able to decide where that money was donated. They chose anywhere from therapeutic horse training camps for those with disabilities, to providing lunches for underserved kids in the summer that don’t have anywhere else to go for lunches.

Their goals for 2018 are to create a solid onboarding platform and onboard three more locations by the end of the year. Their long-term growth plan is to be in two distinct markets with over 50 practices by the end of five years. DMD sites a key success as their growth to five locations in 16 months.

Key executives in group:
Tanner Applegate (CEO)
Dr. Benjamin Bassett (COO)
Dr. Brett Kessler (CCO)

Meridian Dental Solutions was founded by Jeff Minchau, Kent McBride, and Spencer Stiles in 2004. They currently have five locations in WV, PA, and MD. Thus far, they have utilized both de novo and affiliations strategies and plan to add three or four more offices in 2018. They are currently finalizing their DSO structure, changing practice management software, updating financial reporting/tracking, and introducing a more robust benefit package. In the next three to six months, their structure and systems will be much more mature allowing them to aggressively seek opportunities. At that point, they intend to grow as quickly as management and executive teams will allow. For MDS, it is more important to partner with providers that share their values than to find opportunities for profit.

MDS sees the landscape of dentistry changing and wants to play an active role in maintaining the integrity of specialties for the good of patients and referring doctors. Likening themselves to Tesla, Google, or Amazon, they are encouraging disruptive thinking. MDS wants to help innovative ideas grow wings.

Believing that a great team is far superior to a great individual, they are currently creating a curriculum for their newer doctors and team members. Mutual respect, implementing systems to empower dentists to achieve success and relieve stresses, clear communication, harmonious teamwork, and lifelong learning are key components of their business philosophy.

Although still in its infancy, a key success has been the addition of periodontics as a specialty under the group after they realized the synergies between endodontics and periodontics were numerous.

Giving back is important to MDS and they give all providers a generous yearly allowance for dental mission trips, and will be organizing regular ways to donate free dental services.

Key executives in group:
Aaron Seldon RN, MBA, MSN – Chief Executive Officer
Jeffrey Minchau DDS, MS – Chief Clinical Officer
Kent McBride DDS, MS – Chief Development Officer
Spencer Stiles DDS, MS – Chief Financial Officer

While the story began many years ago, Rock Dental Brands was formally organized and founded in 2015 by Drs. Mark Dake and Bryan Hiller. It now has 72 practices in Arkansas, Missouri, and West Virginia. Headquartered in Little Rock, Arkansas, RDB’s growth has occurred primarily through affiliation. The largest single acquisition was Arkansas Dentistry and Braces (19 practices) in 2017. Brands also include Westrock Orthodontics, Leap Kids Pediatric Dental, Impact Oral Surgery and Rock Family Dental.

As a multi-specialty dental service organization, RDB strives for practice density within its geographic footprint. All doctors participate in a robust peer review and compliance program that fosters best practices with no production quotas. AXPM, a sister company, provides multi-specialty practice management software with centralized support features: supplies, lab services, and employee benefit cost savings through a dental industry specific insurance purchasing group with nationally recognized carriers and provider networks.

Rock Dental Brands plans to continue acquiring individual/group practices and building de novo multi-specialty clinics both inside its current geographicfootprint, as well as expansion into other states with strategic dentist relationships.

The group’s mission is to strive for an unmatched dental experience and customer service. A core tenant since the group began is that if they do what is right, everything else will work out.

A key success was the acquisition and onboarding of 29 practices in 2017.

Key executive in group: Drew Ramey, Chief Strategy Officer

Underbite Management was started in 2011 and currently has three locations in Manhattan. The group, founded by David Janash, DMD, has a transparent, dentist-focused model that seeks to help practices grow and protect them from the seismic shifts happening in the industry.

The Manhattan-based company combines a distinctly New York ethos with the same tactics used by the larger mega-DSOs, and offers a comprehensive slate of services and solutions, including human resources, insurance billing and verification, compliance reviews and revenue cycle management. Across its three, state-of- the-art facilities and centralized management, the organization embodies the cultural diversity of the city. A wide array of specialists ensure a streamlined practice flow, increased revenue and convenience for patients.

Underbite Management’s strategy is diverse. They have been involved in acquisitions, chart mergers, office expansions, and even office sublets. Underbite has taken offices that are simple “bread and butter” general practices and turned them into efficient, multi-specialty dental centers with a significant increase in with a focus on case acceptance. In a “vertical city” with residents and visitors from around the world where space is at a premium, it is critical to be a 360-degree solution for patients, offering the basics as well as complex high-tech and cutting-edge procedures and philosophies.

Underbite Management is particular about the “bones” of each practice they work with. The team has to be great and share core values, and the patient and procedure mix has to have potential and a willingness to grow and improve. They look for areas to combat inefficiency and opportunities to expand the repertoire of services offered, while keeping a careful watch to ensure the facility and team aren’t overwhelmed.

Key successes have been:

A six-operatory practice collecting $1.6M a year increased to $2.4M a year by making small, strategic changes using Underbite Management’s network of providers, resources and services. The value of the practice raised from $1.25M to an estimated $2.1M in a few short weeks.
A mature five-operatory partnership collecting $950K per year goes awry when one partner becomes disabled. After finding a buyer, the landlord informs them that their lease will not be renewed. Underbite merges the charts of this practice into one of their offices and a strategic plan is put into place. The remaining partner now generates over $1.6M, has all his headaches eliminated, and is taking home a significantly higher income.

Key executives in group:
Simtra Recai, Regional Manager
Esida Destani, Human Resources Manager
Wing Wong, Director of Finance
Heather Becker, Marketing Manager

Webster Dental Care was founded in 1976 by Steven Rempas, DDS, and didn’t add its second office until 1985. Since then it has grown to 12 Chicago area locations, two within the past month. Its strategy is continued expansion through acquisition of offices in the Chicago area. Webster Dental Care has the goal of acquiring three offices in 2018, while also building an executive office and training center. After that, then intend to add one to three offices every year.

What makes Webster Dental Care unique is that they are owned by two dentists, without any venture capital partners, so they can close on new affiliations quickly. Since they are only dentist-owned, they have realistic goals for providers in terms of their production. They know how doctors like to work. As dentists they understand the needs of the sellers, the attachments they have made to their offices and patients over many years, and they encourage that warm feeling to continue. Offices, which all have an Hawaiian décor theme, offer all specialty services in one facility and are located in geographically diverse communities close to public transport.

Focused on patient care, and not money, Webster wants patients to have a “wow” experience when they visit their offices and not be deluged with people explaining financing options. A firm believer that if they take care of their employees, their employees will take care of the patients, Webster Dental Care Doctors are featured in Chicago Magazine’s January issue Top Doctors.

Webster Dental’s Dr. Jones in Panama with Mission Save a Smile

A key success was being named a “Top Workplace” for seven years in a row by the Chicago Tribune Newspaper.

Key Executives:
Mark Zieba, DDS Partner & Dir. of Professional Dev.
Jon Gregoire, Chief of Operations
Steve Kavetsis, Director of Development
Patrick Blackwell, Equipment
Suzanne Livingston, Front Desk Training
Ed Cammana, Assistant Training
Neesie Lampman, Insurance Relationship Manager

* Emerging groups on this list were chosen from a pool of entrants who submitted information to GDN. GDN based selections by evaluating all applicants’ answers to our questionnaire. GDN received no monetary compensation for including any DSOs on this list.