In most cases, a 1,500 square foot space is sufficient for a startup. That will provide enough room for four chairs in an open format. If you require a doctor's office, private restroom, or break room, a 2,000 square foot space will be needed.

In a few years, if the practice grows as planned, you will need extra space. Extra space comes at a premium — in a shopping center, the adjacent space is likely already occupied, limiting your ability to expand. Special consideration should be given to long-term space needs from the very beginning.

More often than not, the space needed for a practice buildout is not exactly what is available. For example, if you are looking for 1,500 square feet and the available space is 1,750 square feet, a space planner will design the layout to make the best possible use of the entire area.

It is important to have a property frontage that will accommodate a buildout with operatories on the left and right sides of the space, allowing for a central walkway for moving throughout the practice.

Leasable (or rentable) space is measured from the outside wall of the area being leased. Common walls are measured from their center, meaning tenants with a shared wall pay for half the space that wall occupies. This can present confusion for a lessee who measures only the interior dimensions.

Most dentists have a clear idea of the type of practice they wish to establish. If your goal is a high-end practice, it is wise to locate in the portion of the city where residents have higher incomes. Higher-income earners are more demanding but also more likely to invest in comprehensive treatment plans.

A dentist must make a deliberate decision about which income level they are most interested in serving, as each market segment comes with distinct expectations, challenges, and financial rewards.

Yes — banks are well aware of startup financing needs. Some banks specialize specifically in practice financing. A practice broker who works with lending institutions known for processing loan applications rapidly gives you a distinct advantage. Student loan payoffs are not a barrier, because lenders understand that a dentist will generate the revenue necessary to service both educational and business debt.

The bank will want to review several key items before approving a startup loan:

• Loan Application: The first formal step, accompanied by a personal interview with the lending officer.
• Tax Returns: The past three years of tax returns are required. Social security numbers are necessary identifiers and must not be blacked out.
• 10-Year Business Plan: A written plan demonstrating how you intend to grow production over the life of the loan.

Equipment vendors stand ready to supply you with detailed, current pricing proposals. There is a significant amount of equipment that goes into starting a dental practice — from operatory chairs and delivery units to sterilization centers, imaging equipment, and cabinetry.

A practice broker maintains a network of contractors experienced in dental office construction. A referral to a specialized dental contractor is essential for achieving a well-designed, fully functional space. We strongly advise against hiring a general contractor who just finished a kitchen or residential remodel — the costs of removal and reconstruction due to errors in medical-space requirements can be enormous.

Experienced dental buildout contractors create spaces that are not only functional but offer multiple floor plan options to choose from.

You can have the best team members in the world, but without a coach, you win very few games. A buildout expeditor plays a critical leadership role, coordinating the construction team — tile setters, painters, electricians, framers, IT specialists, decorators, and equipment installers — to ensure all parties function together efficiently.

The single biggest time factor is obtaining permits from the city. Zoning and building commissioners are very precise when it comes to approvals. Once permits are issued, a dental contractor will typically complete a 1,500 square foot space within 12–14 weeks, including the installation of ownership-purchased equipment. The presentation of the front door key is the final step.

The city zoning department will first verify the space as a medically zoned location. Once that approval is acquired, the building department will review a copy of the architectural drawings. Upon approval and payment of permit fees, the dental office contractor may begin work. The pace of this process depends largely on the responsiveness of the local city planning department.

Planning and zoning commissioners follow specific city directives dividing areas into zones: single-family housing, commercial, retail, industrial, and medical. Only certain zones are authorized for medical use. The primary reason for medical zoning distinctions is parking — most cities require one parking space for every 1,000 square feet of rental space.

The city building department also inspects the contractor's work phase by phase. Work must stop at each milestone until the city inspector signs off, which is one of the most common causes of buildout delays.

Leases are designed to protect the landlord — their attorney will make that perfectly clear in the proposed document. Key points that must be negotiated include: price per square foot, common area management (CAM) fees, and percentage-of-income clauses. Mall landlords may attempt to collect 3–5% of your practice income on top of the base lease, and some contracts also include a percentage fee if the practice is sold during the lease period.

CAM stands for Common Area Maintenance. Landlords have many property expenses — landscaping, parking lot resurfacing, building repairs, roofing — and they pass these costs on to tenants through CAM charges. These costs are divided proportionally across all tenants based on total square footage in the building. Your share is added to your monthly lease payment alongside the base rent.

A Triple Net (NNN) lease means the tenant pays three primary operating costs in addition to base rent: property taxes, property insurance, and common area maintenance (CAM). These costs are passed directly from the landlord to the tenant and typically result in a lower base rent — but higher overall operating risk for the tenant.

Annual lease increases are a negotiable component of any commercial lease. Currently, in the medical building industry, annual increases run between 3–4%. A Dental Broker can leverage this knowledge during negotiations — the difference between 3% and 4% over a ten-year lease can be substantial.

For best practices, keep your lease on file in the office and review it annually. Kunau & Cline, Inc. maintains all client leases on file and is here to assist when questions arise.

As a matter of prudence, surrounding yourself with dental-oriented professionals is essential. Your core advisory team should include:

• A dental-oriented attorney
• A certified public accountant (CPA)
• A practice management consultant
• A financial planner
• A skilled office manager

Having these professionals available — even on a consulting basis — will keep the practice producing as planned. Retaining your dental real estate broker will also assist in future building purchase planning and practice transition structuring.

There are many qualified interior decorators available to assist with flooring material selection, wall paint coordination, artwork, and signage. They work closely with space planners to bring the entire dental office environment together — creating a welcoming, comfortable atmosphere for patients.

Not every startup uses a professional decorator. Some dentists rely on trusted personnel, a spouse, or their own aesthetic instincts. Either path can produce a beautiful result when executed with care.

A skilled web master will work with a new dentist to discover the owner's personality traits and translate them into a cohesive digital and physical brand identity. The office design and website should be developed in coordination — including logo concepts, letterhead layout, and visual tone.