General Dentistry & Pediatric Dental Practice, 30-Year San Antonio, TX

$682K

SDE

2.2x

Multiple

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Full Editorial Writeup

This is a full-service general dental practice in San Antonio, Texas with more than 30 years of operating history and a deep base of established patient goodwill. The practice runs out of an iconic historic facility and offers a broad service mix including general dentistry, clear aligners, sedation, and implants, with a rare in-house lab and modern CBCT imaging. The combination of longevity, a full-service model, and higher-margin surgical and cosmetic procedures gives it a wider revenue base than a bread-and-butter cleanings-and-fillings shop.

The practice generates $682,000 in owner cash flow and is priced at $1,495,000, a 2.19x multiple that sits at the attractive end of the range for a dental practice with this level of tenure and profitability. The listing is positioned toward a first-time doctor-buyer who can qualify for close to 100% bank or SBA financing on the strength of the historical numbers, so the equity check at close can be modest relative to the earnings.

The seller is offering hands-on transition support to protect goodwill, which matters in dentistry where patient and referral relationships often follow the treating doctor. Named growth levers include expanding beyond the current 4-day workweek, modernizing digital marketing, and pushing more high-margin surgical volume through the existing chairs and lab.

Why we like it

Earnings quality is strong for the category: $682,000 in cash flow on a 30-year book of patients, with a diversified service mix spanning general dentistry, aligners, sedation, and implants. A practice this old carries repeat recall visits and referral flow that make the earnings less lumpy than a young office chasing new patients.
The moat is patient goodwill and switching friction. Three decades in the same market with an established, full-service base means families rarely leave, and the in-house lab plus CBCT lets the practice keep high-margin surgical and lab work in-house rather than outsourcing it. That vertical integration is a real cost and margin edge most single-doctor offices lack.
Dental demand is durable through downturns. People defer some elective cosmetic work, but pain, restorations, pediatric care, and hygiene recalls keep coming, and the pediatric component adds a steady, insurance-backed patient stream. This is exactly the kind of boring, needs-based cash flow that compounds through cycles.
The deal is structured for a buyer to win on day one. At 2.19x cash flow with a track record that supports near-100% bank financing, a qualified dentist can control $682,000 of earnings with minimal upfront capital. The named upside (expanding past a 4-day week, better marketing, more surgical volume) is executable without reinventing the business.

How to improve it

Extend the schedule beyond the current 4-day workweek. Adding a fifth clinical day, or evening and Saturday blocks, uses chairs and staff you already pay for and can lift revenue meaningfully without new fixed cost. Test demand with recall patients before committing to permanent hours.
Push high-margin surgical and implant volume through the existing CBCT and in-house lab. Implants, sedation cases, and full-arch work carry far better economics than routine hygiene, and you already own the imaging and lab infrastructure to keep the work in-house. Build a treatment-plan review process so hygienists and associates flag surgical candidates.
Modernize digital marketing and online booking. A 30-year practice often relies on word of mouth and neglects Google reviews, local SEO, and paid search that drive new-patient acquisition. A modest monthly spend plus a reactivation campaign to lapsed patients can fill open chairs quickly.
Review the payer and fee mix and renegotiate low-reimbursement plans. Long-tenured practices frequently carry outdated PPO contracts or unadjusted fee schedules. Repricing procedures to current market and dropping the worst-reimbursing plans can add margin without adding a single patient.
Build associate-doctor capacity to de-risk key-man dependence. Bringing on an associate lets the practice see more patients, opens weekend or extra-day coverage, and reduces reliance on a single treating doctor, which also raises the resale value at exit. Structure comp on production so it self-funds.
Optimize the hygiene recall system and reactivate dormant patients. A tight recall cadence with automated reminders recaptures no-shows and lapsed families who already trust the practice. This is the cheapest revenue in dentistry and directly lifts hygiene and downstream restorative production.
Audit the in-house lab economics and utilization. Confirm the lab is running efficiently and consider offering lab services to nearby practices if capacity allows. An underused lab is trapped margin; a fully loaded one becomes a second profit center.

Diligence notes

Get actual gross revenue and a full P&L, since revenue is not disclosed and only cash flow is shown. You need the top line to judge margins, the payer mix, and whether the $682,000 includes owner add-backs that would not persist for a buyer. Reconstruct SDE independently rather than trusting the headline figure.
Verify the real estate situation. The facility is described as an iconic historic building and listed as owned, but the asking price does not clearly include real estate. Clarify whether you are buying the building, leasing it from the seller, and what the lease terms and rent are, because occupancy cost directly changes the true cash flow.
Analyze how much of the earnings depend on the departing doctor personally producing dentistry. If the seller is generating a large share of implant, sedation, and surgical production, a buyer without those skills could see revenue drop post-close. Quantify production by provider and by procedure before setting the price.
Confirm the age, condition, and remaining life of key equipment, especially the CBCT unit, chairs, and the in-house lab. Older imaging and operatory equipment can require six-figure replacement soon after close. Factor any deferred capital expenditure into the effective purchase price.
Pull patient counts, active-patient definition, new-patient flow, and retention over the last three years. A 30-year practice can quietly be shrinking as its patient base ages, so you want the trend, not just a snapshot. Also review insurance-versus-fee-for-service mix and any concentration in low-reimbursement plans.

Source

Originally listed on BizBuySell. View original listing →