The largest DSOs headed into 2026

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The top 10 largest DSOs support a combined network of roughly 7,800 practices nationwide.

Here are 10 of the largest DSOs and MSOs in the U.S. by number of affiliated or supported dental practices:

Contact Ariana Portalatin at aportalatin@beckershealthcare.com with questions or updates for this list.

1. Heartland Dental — More than 1,800 practices 

2. The Aspen Group — More than 1,300 practices

3. PDS Health — Approximately 1,100 practices

4. Smile Brands — More than 600 practices

5. MB2 Dental — More than 800 practices

6. Sonrava Health — nearly 600 offices

7. Smile Doctors — More than 550 practices

8. Affordable Care — Approximately 425 practices 

9. Dental Care Alliance — More than 400 practices

10. Specialized Dental Partners — More than 250 practices

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