Prepared for lenders, CDCs, and federal agencies to SBA SOP 50 10 8, USDA 7 CFR Part 5001, and conventional underwriting standards. Fiduciary duty runs to the lender and the agency, never the borrower. 4,000+ engagements since 1998 covering $41.2 billion in evaluated project value. So far in 2026: 41 engagements and $1.54 billion evaluated — 17 SBA, 11 USDA.
Dental facilities — general practices, pediatric and orthodontic offices, oral-surgery centers, and multi-site DSO locations — are chair-economics businesses: production per operatory, the provider hours that fill the chairs, and a payer mix spanning PPO contracts, fee-for-service, and Medicaid that prices identical procedures very differently. The study sizes patient demand from population-to-dentist ratios in the draw area, models production by operatory against provider capacity, and validates the buildout budget at clinical costs — plumbing, imaging, sterilization — that commodity office space never carries.
Demand from dentist-per-capita gap analysis and competitive census, production modeling per operatory at procedure-mix yields by payer, hygiene-department economics modeled separately as the recurring base, startup ramp from documented new-practice curves, and acquisition analyses tied to verified production history rather than asking-price narratives.
Every Wert-Berater financial model is fully linked with no hardcoded values, so any reviewer can stress any input. Deliverables comprise a complete narrative report and the linked Excel model, with ten-year pro forma, sensitivity analysis at ±5, 10, and 15 percent, interest-rate stress from +0.5 to +3.0 percent, and ratio analysis benchmarked against RMA and IBISWorld data.
SBA engagements are prepared to SOP 50 10 8, including its debt-service-coverage minimums of 1.15x operating and 1.00x global. USDA engagements follow RD Staff Instruction 5001 across the Business & Industry, Community Facilities, REAP, and Value-Added Producer Grant programs. Conventional engagements are built to the lender's stated coverage standard, typically 1.20x. Owner-dentist projects are core SBA territory — practice acquisitions, ground-up buildings, equipment packages; DSO-affiliated expansions route conventional with the management agreement reviewed.
The firm's professional-practice underwriting applies its standard throughput discipline to the operatory: chairs, hours, and yield. Independence is non-negotiable: determinations follow the evidence and are not revised under pressure, and studies are built to pass lender, agency, and third-party review without exception items.
A feasibility study for a dental or oral surgery facility goes well beyond a generic cash-flow projection. Because production is constrained by physical operatories, provider hours, and payer-contract rates rather than by square footage or occupancy, every deliverable is built around those three constraints from the first worksheet forward.
Demand for dental services is population-driven and geographically bounded. Patients rarely travel more than a defined radius for routine care; oral surgery and specialty services draw from a wider but still measurable area. The analysis begins by delineating a primary and secondary draw zone using drive-time polygons rather than arbitrary radius circles, then layers population and demographic data onto that geography.
Dentist-to-population ratios are assembled from state dental licensing board registries, which record active licensees by practice address, and cross-checked against National Provider Identifier records maintained in the CMS NPPES database. Both sources are public and updated on a rolling basis, giving an accurate active-provider count rather than a stale directory estimate.
Competitive supply is inventoried by physical site visit and confirmed against Google Maps business listings, state board records, and local health department filings. For oral surgery specifically, hospital-based oral surgery departments and ambulatory surgery center rosters filed with the state health department are included in the competitive count because they compete for the same referral base.
Payer-mix context is drawn from state Medicaid managed-care enrollment data, insurer network directories, and, where available, Health Resources & Services Administration shortage-area designations, which also inform USDA Community Facilities and SBA underserved-market analyses. Traffic and access patterns are reviewed where a ground-up or relocation project depends on visibility and ingress.
A small change in any one of four inputs can move a dental or oral surgery facility from bankable to marginal. The study isolates each, documents the source, and stress-tests it across the sensitivity matrix so the lender can see exactly where the margin disappears.
SBA credit officers reviewing a dental practice or oral surgery facility under SOP 50 10 8 focus first on whether the study was prepared by an independent third party with no contingent fee, and second on whether the 1.15x operating and 1.00x global coverage minimums are met on realistic — not optimistic — assumptions. Because owner-dentist transactions are core SBA professional-practice territory, the agency expects the study to address prior-year production history for acquisitions, or documented population need for startups, not simply a business plan narrative.
USDA Business & Industry and Community Facilities reviewers apply 7 CFR Part 5001 and look specifically at whether the facility serves a rural population with documented access gaps. Dental and oral surgery facilities qualify under Community Facilities when they serve a community of eligible size; the study must address the service-area population, existing provider supply, and the project's ability to sustain debt service without ongoing subsidy.
Conventional lenders typically require 1.20x coverage and place additional weight on the owner-dentist's personal production history, the transferability of the patient base in an acquisition, and the collateral coverage of the equipment package. For DSO-affiliated locations, lenders review the management agreement to understand fee obligations that reduce effective cash flow before debt service. The study addresses each of these angles explicitly so the credit memo can cite the feasibility report rather than reconstruct the analysis from scratch.
The fee for a dental practice or oral surgery facility feasibility study is fixed and quoted in writing within one business day of an initial inquiry. No portion of the fee is contingent on the outcome, and the determination is not revised because a sponsor disagrees with the finding. That structure is a requirement of the SBA and USDA programs the studies support, and it is also the only arrangement consistent with a fiduciary duty that runs to the lender and reviewing agency rather than to the borrower.
Standard delivery is ten to fifteen business days from receipt of a complete data room. For dental and oral surgery projects, a complete data room includes the prior three years of production reports (for acquisitions), the signed lease or purchase agreement, contractor bids or a detailed buildout estimate, the equipment package, the proposed fee schedule, payer-contract summaries, and provider employment or associate agreements. Rush delivery is available when a rate-lock or closing deadline requires it.
Every engagement is published to a secure client portal where the linked Excel model stays live. Because every cell is formula-driven with no hardcoded values, a credit officer can change the operatory count, the payer mix, or the interest rate and watch every downstream ratio recalculate immediately. That transparency is not a feature added for convenience; it is the standard the firm has applied to every engagement since 1998, across 4,000+ engagements representing $41.2 billion in evaluated project value.
The fee is fixed, quoted in writing within one business day, and does not vary with the loan amount or the study outcome. No portion is contingent on a favorable finding. Because scope varies by project type — a single-operatory startup differs from a multi-site oral surgery center — the quote is specific to the engagement after a brief intake conversation.
Standard delivery is ten to fifteen business days from receipt of a complete data room. The most common delay is an incomplete data room: missing production reports, unsigned leases, or absent equipment schedules add time. Rush delivery is available when a closing or rate-lock deadline requires a shorter turnaround; that option and any associated fee adjustment are disclosed in the engagement letter.
Three factors distinguish this asset class. First, revenue is bounded by physical operatory count and provider hours, so there is a hard ceiling on production that a general revenue-growth assumption can easily overstate. Second, payer-mix complexity — PPO contractual adjustments, Medicaid fee schedules, and fee-for-service rates pricing identical procedures very differently — means net yield must be modeled by payer tier, not blended. Third, for oral surgery centers, referral-base concentration risk requires a scenario analysis that most sponsor projections omit entirely.
Studies are prepared to SBA SOP 50 10 8, including its independence requirements and its 1.15x operating and 1.00x global debt-service-coverage minimums. The firm does not represent that any agency has pre-approved or endorsed its work; acceptance is the lender's and agency's determination. The study is built to pass review without exception items, and the fiduciary duty runs to the lender and agency, not the borrower.
A complete data room for an acquisition includes three years of practice management software production reports (not tax returns alone), a payer-mix breakdown by year, the current fee schedule, provider schedules showing hours worked, and any associate or hygienist employment agreements. Tax returns are reviewed alongside production data because discrepancies between the two are an underwriting concern the study must address directly.
Yes. USDA engagements follow 7 CFR Part 5001 across the Business & Industry, Community Facilities, REAP, and Value-Added Producer Grant programs. Dental and oral surgery facilities serving eligible rural communities qualify under Community Facilities when population thresholds are met. The study addresses service-area population, existing provider supply, documented access gaps, and the project's ability to sustain debt service — the specific factors USDA reviewers examine.
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Wert-Berater, Inc. is an independent provider of feasibility studies and other related services. The firm does not provide financing or equity investment advice, and does not arrange, broker, or place debt or equity capital of any kind.
All appraisal assignments are performed by Bruce E. Jones, MAI, ASA-GC, BCA, CMEA, a member of the Appraisal Institute since 2006, a staff member of Wert-Berater, Inc. and owner of Special Purpose Realty Valuation.