Texas, Florida and Connecticut have seen the most DSO activity during the fourth quarter of 2025.
Becker’s compiled a list of more than 70 DSO affiliations, openings and acquisitions during the fourth quarter.
Here is how DSOs expanded in these states:
Texas: 11
Chicago-based Aspen Dental opened locations in Seguin, Nacogdoches, Palestine and Midlothian.
Henderson, Nev.-based PDS Health added Harpers Kids’ Dentistry and The Groves Dental Group.
Dallas-based Smile Doctors completed two expansion acquisitions with affiliated doctors: True Smile Orthodontics and Pendleton Orthodontics.
Dallas-based Apex Dental Partners expanded its network in Texas in November.
Choice Dental Group opened a location in Killeen.
Jenks, Okla.-based Lumio Dental purchased a dental practice in Southlake.
Florida: 9
Scottsdale, Ariz.-based Imagen Dental Partners affiliated with Alexander Dental in St. Augustine, Fla.
Henderson, Nev.-based PDS Health added Kissimmee (Fla.) Modern Dentistry.
Effingham, Ill.-based Heartland Dental affiliated with Optimum Dentistry, South Tampa Dentistry, Clearwater Dentistry, New Port Richey Dentistry, Riverview Dentistry, Seminole Dentistry, Tampa Dentistry.
Connecticut: 6
Dallas-based Smile Doctors added Daniels Orthodontics and Team Demas Orthodontics.
Danbury, Conn.-based Archway Dental Partners acquired five dental offices in Connecticut.
