DDSWhat is a management services agreement?
A management services agreement is a contract in which a DSO or management company supplies staffing, IT, billing and similar services to a practice and is paid a management fee. The New Jersey Dental Association describes this pure management model as one where the dentist owns the practice. See the consolidation overview.
This is general information, not legal advice; have counsel review any agreement.
Why do states limit who can own a dental practice?
The corporate practice of dentistry doctrine keeps clinical decisions with licensed dentists. One state dental association cites a statute barring a dentist from practicing for an entity not owned and controlled by a licensed dentist. States express the rule differently, so the structure that works in one may not work in another.
What does an MSA usually cover?
Typically the services provided, the fee, the term and termination, who owns which assets, access to records and limits on the DSO’s influence over clinical decisions. Fee formulas and control provisions are where regulators and counsel tend to focus, and terms differ widely, so DDSIntel does not publish typical fee levels.
Why do MSAs matter for transition data?
Because they are invisible in public filings. A practice can become DSO-affiliated with no change to its licensed owner, entity name or address. That is why DDSIntel treats public-record counts of DSO-affiliated locations as a floor, and reads entity, officer and address changes as corporate signals.
See how many dental practices DSOs own, what a DSO is and corporate signals. Ownership trends are in the data hub, and the seller’s view is in who buys dental practices.
Frequently asked questions
What is a friendly PC in dentistry?
A structure in which a licensed dentist owns the practice entity while a DSO provides management under a contract. Have counsel review how it applies in your state.
Are management services agreements public records?
Generally no. They are private contracts, which is why public-record counts of DSO affiliation are a floor.
Can a DSO own a dental practice outright?
It depends on the state. Many states require licensed dentists to own and control practices; others allow business entities with limits on clinical control.
How common is DSO affiliation?
16.1% of U.S. dentists were DSO-affiliated in 2024 (ADA Health Policy Institute), up from 13% in 2022.
Sources
- New Jersey Dental Association. Dental support organizations in New Jersey: how they operate and how ownership works. njda.org.
- ADA Health Policy Institute. The U.S. Dentist Workforce, 2025 update. ada.org.
- American Dental Association. More dentists affiliating with DSOs (ADA News, June 2023). adanews.ada.org.
- ADA Health Policy Institute. Dental practice research (DSO affiliation and practice ownership). ada.org.
Questions or corrections: request a correction. Markdown version: /dso/management-services-agreements.md.