These are the top 10 DSOs in the U.S.

Dental service organizations (DSO) Heartland Dental, TAG - The Aspen Group, and Pacific Dental Services continue as the top three largest DSOs in the U.S., respectively. However, Heartland was the only one to add significantly more practices in 2024.

Heartland Dental opened or affiliated with about 50 more practices since DrBicuspid's last list was published in the spring of 2024.

Since our last ranking, MB2 Dental also moved up the ranks. In addition to adding more practices, it expanded into four more states. Additionally, DSO Affordable Care, which made it on DrBicuspid's top 10 list in June 2023, grew, adding at least 10 more practices.

Top 10 DSOs

Organizations are ordered by the number of affiliated practices. All company websites were last accessed on December 16, 2024.

1. Heartland Dental

Number of affiliated/supported practices/offices: 1,750+
Brands: Individualized
Locations: 39 states and the District of Columbia
Note: In August, Heartland Dental announced it made significant progress, including affiliating with practices and opening new offices, in the first half of 2024
Source: Press release dated October 1.

2. TAG – The Aspen Group

Number of affiliated/supported practices/offices: 1,100+
Brands: Aspen Dental, ClearChoice Dental Implant Centers
Locations: 45 states
Note: In March, Aspen Dental promoted Lori D'Anna to the role of president of field operations.
Source: Company website.

3. Pacific Dental Services (PDS)

Number of affiliated/supported practices/offices: 1,000+
Brands: Individualized
Locations: 24 states
Note: In June, PDS, which rebranded to PDS Health in April, marked its anniversary with 1,000-plus practices.
Source: Press release dated June 25.

4. MB2 Dental

Number of affiliated/supported practices/offices: 700+
Brands: Individualized
Locations: 44 states
Note: In December, MB2 Dental entered Iowa.
Source: Press release dated December 10.

5. Smile Brands

Number of affiliated/supported practices/offices: Nearly 700
Brands: 75 brands, including Bright Now! Dental, Castle Dental, Merit Dental, Midwest Dental, Monarch Dental, Mondavi Dental, A+ Dental Care, Decision One Private Practice Group, and Johnson Family Dental
Locations: 30 states
Note: Smile Brands has not affiliated with any new practices in 2023 and 2024.
Source: Company website

6. Sonrava Health

Number of affiliated/supported practices/offices: 588
Brands: Western Dental, Mid-Atlantic Dental Partners, Brident Dental & Orthodontics, Rich Orthodontics, DentalWorks
Locations: 21 states
Note: In March, Sonrava Health, which includes DSO Western Dental, named a new chief revenue operations officer.
Source: Press release dated June 26.

7. Affordable Care (tied)

Number of affiliated/supported practices/offices: 450+
Brands: Affordable Care Dentures & Implants, DDS Dentures + Implant Solutions, Advanced Dental Implant Center
Locations: 43 states
Note: In November, Affordable Care chose Weave's platform for its practices.
Source: Press release dated October 30.

7. Smile Doctors (tied)

Number of affiliated/supported practices/offices: 450+
Brands: Individualized
Locations: 31 states
Note: In February, Smile Doctors announced that it has six de novo locations in development for 2024.
Source: Company website

8. Dental Care Alliance

Number of affiliated/supported practices/offices: 400+
Brands: Individualized
Locations: 24 states
Note: In August, Dental Care Alliance partnered with Patient Prism, an artificial intelligence-enabled call recording software application.
Source: Press release dated November 26.

9. Freedom Dental

Number of affiliated/supported practices/offices: 350+
Brands: Individualized
Locations: 42 states
Note: Freedom Dental has not added any new practices in 2024.
Source: Company website

10. Great Expressions Dental Centers

Number of affiliated/supported practices/offices: 300+
Brands: Great Expressions, Ascent Dental Care
Locations: 10 states
Note: Great Expressions has not added any new practices in 2024.
Source: Company website

Honorable mention: North American Dental Group

Number of affiliated/supported practices/offices: 240+
Brands: Individualized
Locations: 15 states
Note: In June 2023, dentists in the U.S. sued Zahn Parent, an affiliate of the North American Dental Group, seeking data to explain what may have diluted their ownership shares in the firm, potentially hurting their retirement and finances.
Source: Company website

The list of the largest DSOs is based on DrBicuspid.com's research of readily available public information. The information presented is not meant to be definitive but rather to provide a snapshot of the available data on the largest DSOs. In each instance, the information has been gathered through an organization's website, press releases, previously published material, or other sources.