Top 8 largest DSOs

Below is a list of the eight largest dental service organizations in the U.S.

Editor's note: This list is not exhaustive and is arranged in alphabetical order. Each organization has 300 or more affiliated practices, as listed in press releases or on the organization's website. Please contact Gabrielle Masson at with any questions.

Affordable Care (Morrisville, N.C.). Founded in 1975, Affordable Care is the largest DSO dental focused on tooth replacement services in the U.S. The organization has more than 340 practices across 40 states and brands itself as Affordable Dentures & Implants, as well as DDS Dentures + Implant Solutions.

Aspen Dental Management (East Syracuse, N.Y.). With more than 850 locations across 42 states, this DSO is one of the largest in the U.S. In 2019, the DSO partnered with Walgreens to offer in-store dental services to Walgreens customers. Aspen Dental Management is set to acquire ClearChoice Management Services by the end of 2020.

Dental Care Alliance (Sarasota, Fla.). Established in 1991 by Steven Matzkin, DDS, Dental Care Alliance is affiliated with more than 320 dental practices across 20 states, with more than 700 dentists in its network. Some of its affiliated brands include Baystate Dental, Dental One Associates and American Dental Center.

Great Expressions Dental Centers (Southfield, Mich.). This DSO was acquired by Atlanta-based private equity firm Roark in 2016. It now comprises more than 300 affiliated practices, 500 dentists and 450 hygienists. Great Expressions was the first recipient of the Summit Compliance Award from Mesa Labs for its commitment to infection control.

Heartland Dental (Effingham, Ill.). Founded in 1997 by Rick Workman, DMD, this DSO is the largest in the U.S., with nearly 1,100 affiliated practices. The company supports over 1,700 dentists across 38 states. In 2020, Heartland Dental expanded its reach into Idaho and has also recently opened support hubs in Indianapolis and St. Louis to enhance its non-clinical administrative services.

Pacific Dental Services (Irvine, Calif.). This DSO was founded in 1994 with its first supported dental practice in Costa Mesa, Calif. Today, Pacific Dental Services provides business support services to over 800 dental practices throughout 23 states. PDS has earned a spot on the Inc. 5000 list of the fastest growing private companies in the U.S. 14 times.

Smile Brands (Irvine, Calif.). This DSO was founded in 1998 by a management team that included its current CEO Steve Bilt and CFO Brad Schmidt. Smile Brands acquired Midwest Dental at the end of 2020, a DSO with 230 offices located primarily in the upper Midwest and New England. The combined company represents 650 offices and over 8,000 employees in 30 states.

Western Dental (Orange, Calif.). With almost 320 locations, Western Dental is California's largest oral healthcare provider. The DSO operates in California, Nevada, Arizona, Texas and Alabama and supports over 900 licensed dental providers. In January 2020, Western Dental released its own orthodontic aligner, ClearArc.

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