Fractional CFO Services for Dental Practices
Financial leadership for dental practice owners collecting $1M to $5M a year. We help you get overhead under control, see what each part of the practice really earns, pay yourself on purpose, and make big decisions like a new associate, a fee change, or a second location with real numbers in front of you.
Talk to a CFO Who Understands Dentistry
We'll look at your numbers with you and show you where the profit is hiding. Free, no obligation, no pitch.
Book My Free Cash Flow Call Not ready to talk? Check your overhead with the free 60-second Profit Margin CheckupFree 30-minute call · No sales pressure · Just an honest look at your numbers
Does Any of This Sound Familiar?
None of that means you're a bad business owner. Dental school teaches you to treat patients, not to read a cash flow statement. And a busy practice can hide a lot: high collections can cover for overhead that's too high, owner pay that comes last, and debt payments that never show up on the P&L. What most practice owners are missing isn't another report. It's someone who looks forward and helps them decide what to do next.
What Fractional CFO Services Look Like for a Dental Practice
We work alongside you twice a month as your financial partner. We get your numbers right, build the tools you need to plan, and help you make the big calls with real numbers instead of gut feel.
Overhead You Can Actually Manage
Your overhead ratio broken into staff, lab, supplies, facility, and marketing, compared to what well-run practices spend, with a clear list of what to fix first.
Margins by Type of Dentistry
What hygiene, restorative, implants, ortho, and cosmetic work really earn once lab and supply costs are matched to the procedures they belong to.
A Cash Forecast That Fits Your Practice
Built around your slow and busy months, insurance payment timing, big prepaid cases, and the lab bills that follow them, so a great month doesn't turn into a cash crunch.
Owner Pay and Tax Planning
A reasonable salary, regular distributions, and money set aside for taxes every month, so you get paid on purpose and nothing surprises you at year end.
Production and Collection Targets
Your break-even month, your target month, and what each provider and the hygiene department need to produce to get there.
Big Decisions, Modeled First
New associates, dropping a PPO, raising fees, new equipment, or buying a second practice. We run the numbers before you commit.
Case Study 1: From Scrambling Every Month to Running the Numbers Himself
This dentist bought his Texas practice in 2012 and grew it into a busy fee-for-service office with a strong implant and full-arch focus. By the time he came to us, the practice was collecting about $2.5 million a year. It didn't feel like it. His reserves were drained, he was rarely paying himself, and he couldn't tell where the money was going.
"We have built this super-powered race car, and we're still in traffic."
Practice owner, general and implant dentistryHis books were actually clean. The problem was that nobody had ever shown him how to use them. His accountant's reports were built for taxes, not for running a practice. He had never looked at a cash flow statement, so he couldn't see how debt payments and his own draws explained the gap between the profit on paper and the cash in the bank. And because his big full-arch cases were paid up front while the lab bills came months later, a great month and a cash crunch were often the same month.
What we built together
- Moved lab and supply costs out of overhead and into the cost of the procedures, so he could see what each type of dentistry actually earned.
- Set production targets he could manage to: his break-even month, a target month, and a goal for the year.
- Built a monthly money plan: taxes set aside, a separate account for the lab bills on prepaid cases, a regular owner distribution, and reserves.
- Recalculated his tax set-aside so it matched what he would actually owe.
- Handed bill entry to a team member, with him approving payments, so the numbers stopped living in his head.
The most important change was what he did with the record month. Instead of spending it, he ran his first monthly allocation himself: about $17,000 to the tax account, money held back for an upcoming lab bill, a modest distribution for himself, and about $26,000 left in reserves. When August came in slow, that cushion carried the practice.
"The only thing that made August survive August was July... Okay, I can't spend this."
Practice owner, general and implant dentistryWith a real picture of his numbers, he was able to evaluate an all-cash offer on a second practice and its building, model what patient attrition would do to it, and decide on his terms. Profit isn't fixed in a few months, and his practice still has overhead work ahead. The difference is that he now sees it, and he knows which levers to pull. Read the full case study.
"I wish I had this years ago because it would have made me a better owner."
Practice owner, general and implant dentistryCase Study 2: Finding the Leaks in a PPO Practice
This owner took over an established family practice in late 2023 and added a second office. Production was strong, but the year before he came to us the practice lost money. Payroll was running close to half of collections, against the 25% to 30% most practices aim for. Insurance write-offs were taking more than half of every dollar billed, his credit lines were maxed, and he had about $8,000 in the bank.
"I constantly feel like I'm behind on my bills for my vendors."
Practice owner, two-office PPO practiceWhat we did as his fractional CFO
- Cleaned up the books, including loans that were missing from the balance sheet and $188,000 of uncategorized expenses, and connected QuickBooks to a live dashboard.
- Built scorecards for each doctor and a weekly bill-pay routine, so bills stopped getting paid only when they were overdue.
- Prepared him for his bank meeting with a clear, specific ask to consolidate his debt into one loan.
- Made collections the number one project, with a daily target, a color-coded weekly dashboard, and a bonus plan for his billing lead.
- Modeled the hygiene schedule and each insurance plan, which led him to drop his two lowest-paying networks.
Cash in this practice is still tight. Insurance write-offs and staff turnover are real headwinds, and the work isn't finished. What changed is that he knows where every dollar is going, which numbers to watch each week, and what to fix next.
"My peace of mind, like my stress level has gone down substantially."
Practice owner, two-office PPO practice"I appreciate that you're not the type of CFO that advises in your own self-interest."
Practice owner, two-office PPO practiceWant to Know Where Your Practice Actually Stands?
We'll walk through your overhead, cash flow, and owner pay on a free call. Just an honest look at your numbers.
Book My Free Cash Flow CallNo sales pressure · Just an honest look at your numbers
What We Usually Find in the First 30 Days
Every practice is different, but the same money leaks show up again and again. These are real examples from dental practices we've worked with.
Profit on paper, no cash in the bank
Your P&L doesn't show loan principal or your own draws. A practice can report a healthy profit while its cash shrinks every month. One owner had never seen a cash flow statement. The first time he did, the gap he'd been feeling for years finally made sense.
Lab bills that arrive months after the money
Implant and full-arch patients often pay up front, but the lab bill can land months later. Without a separate account for those bills, a record month gets spent and the practice is short when the invoices come due.
Half of what you bill never arrives
One PPO-heavy practice was keeping about 45 cents of every dollar it billed after insurance write-offs, with hundreds of thousands of dollars owed to it on paper. Denied claims weren't being resubmitted and pre-authorizations weren't consistent. Fixing the process was worth more than any amount of extra production.
A hygiene department that loses money
When we modeled one practice's schedule, the doctors were profitable but hygiene was losing about $21,000 a month. Appointments ran long, schedules weren't full, and collections per hygiene visit were well below what other practices bring in.
Patient financing fees nobody tracks
Twelve-month interest-free plans can cost the practice around 10% of the case, and some lenders take 15% to 20%. On one $43,000 full-arch case, the financing fee was about $3,000, roughly the same as the lab bill.
Benchmarks that don't fit your practice
Generic targets like 4% for lab and 4% for marketing don't work for a fee-for-service or surgical practice. Your targets should come from your own mix of dentistry, not an industry average built on PPO offices.
Money sitting in the wrong place
We've seen a state payroll tax rate set wrong for years, with about $20,000 owed back to the practice, along with unused software, vendor contracts nobody had reviewed, and fees that hadn't been raised in two years.
Dental Practice Benchmarks
Here is where dental practices typically land, as a share of collections.
| Metric | Average | Strong | Best in class |
|---|---|---|---|
| Overhead ratio | 62% to 68% | 55% to 60% | Under 55% |
| Net profit after owner salary | 8% to 13% | 15% to 22% | 25%+ |
| Staff costs | 27% to 32% | 24% to 27% | Under 24% |
| Lab costs | 10% to 13% | 8% to 10% | Under 8% |
| Supplies | 6% to 8% | 4% to 6% | Under 4% |
| Collection rate | 92% to 95% | 96% to 98% | 98%+ |
On $1.2M in collections, the difference between 62% and 55% overhead is $84,000 a year in owner income. Same patients, same procedures. For the full breakdown by type of dentistry, see our guide to dental practice profit margins, or check your own numbers with the free Profit Margin Checkup.
What a Dental CFO Handles That Your Accountant Can't
Provider Compensation
Associate pay as a percentage of production or collections, daily minimums, and what your own production is really worth, so every doctor is profitable.
Hygiene Department
Hygienist pay against production, recall and reactivation, and whether hygiene is carrying its share of collections or quietly losing money.
PPO and Fee Decisions
What each insurance plan really pays after write-offs, what dropping a plan would do to your numbers, and when your fees are due for an increase.
Collections and Insurance AR
Production versus collections, slow claims, patient balances, and financing fees, so the money you earn actually reaches the bank.
Debt and Equipment
Practice loans, equipment like mills and scanners, and lines of credit, with a payoff plan and a clear answer on what you can afford next.
Second Locations and Buying a Practice
Seller financials, patient attrition, rent as a share of production, and whether your current practice can carry the transition.
Dental Practices We Work With
We've worked with over 315 businesses, including many healthcare practices. Our dental clients typically collect $1M to $5M a year and include:
Our team is based in Salt Lake City and Pittsburgh and works with dental practices across the United States. Everything runs remotely through video calls, shared dashboards, and access to your accounting system, so you get the same CFO partnership wherever you are.
Free Guides for Practice Owners
- Dental practice profit margins: overhead benchmarks and owner pay
- Case study: a Texas dentist from cash anxiety to a $2.2M acquisition offer
- Case study: a dental practice that was profitable on paper and cash-poor
- Why you can be profitable on paper and never have cash
- How to pay yourself as a business owner
- How much does a fractional CFO cost?
- More client case studies
Frequently Asked Questions
A fractional CFO gives you senior financial leadership part time. For a dental practice that means breaking down your overhead, showing what each type of dentistry earns, building a cash forecast around insurance timing and big prepaid cases, setting your owner pay and tax savings, and helping you decide on associates, fees, PPOs, equipment, and new locations. Most of our dental clients collect $1M to $5M a year.
Your CPA files your taxes and reports what already happened. A fractional CFO looks forward. We forecast your cash, set production and overhead targets, plan your owner pay, and sit with you twice a month to make decisions. We work alongside your CPA and bookkeeper, not instead of them.
Our fractional CFO services run $3,500 to $6,000 a month depending on complexity, such as the number of locations, providers, and entities and how much cleanup the books need. There is a one-time $6,000 onboarding fee for the first 30 to 60 days, when we review your books, build your forecast and dashboard, and do a full overhead and margin review. For owners who want to learn to run their own numbers, we also offer a financial coaching program.
Most dental practices run overhead at 62% to 68% of collections. Well-run practices stay at 55% to 60%, and the best come in under 55%. Staff costs are usually the biggest piece at 25% to 30% of collections, followed by lab, supplies, and facility costs.
Yes. We look at what each plan really pays after write-offs, how many active patients it brings, and what your production and collections would look like if some of those patients left. That turns a scary decision into a set of numbers you can weigh.
Yes. We review the seller's numbers, model patient attrition and the rent or building cost, and check whether your current practice can carry the transition. We don't replace your attorney or broker, but you'll walk into the decision knowing what the deal does to your cash and your income.
Yes. We work with whatever practice management software you use alongside QuickBooks. We pull production by procedure from your practice software and match it to your books, so lab and supply costs line up with the work that created them.
We work with dental practices throughout the United States. CFO calls, dashboards, and reporting all run remotely, so location doesn't limit what we can do for you.
Ready to Keep More of What Your Practice Collects?
Book a free cash flow call. We'll look at your practice's numbers together and show you what a fractional CFO would fix first.
Book My Free Cash Flow Call Or start with the free Profit Margin CheckupFree 30-minute call · No sales pressure · Just an honest look at your numbers
Building better Business Owners through personalized Financial Coaching.