Dr. Rae Orraca-Tetten shares her journey from considering an acquisition to ultimately launching a successful dental startup that grew from 3 to 10 operatories. She explains why a startup was more cost‑effective for her personality, clinical style, and long-term goals—despite early recommendations to purchase the practice she worked in. Dr. Orraca-Tetten breaks down how she phased her buildout, accelerated production from day one, and strategically expanded into a neighboring suite as patient demand exploded.

Her experience provides a candid and highly practical look at startup budgeting, confidence, production expectations, and the mindset required to scale quickly.

Topics include:

●       Why purchasing an older practice didn’t fit her vision or financial goals

●       How she launched with 3 operatories and expanded to 10 within six years

●       Cost differences she observed between startups and acquisitions

●       Building a team, managing overhead, and optimizing operatory utilization

●       Expanding into adjacent space and planning for future associate opportunities

●       How personal drive and clinical confidence shape the startup path

●       Advice for dentists choosing between buying and building

In this episode, Dr. Harry Snydman brings a rare dual perspective as both a long-time practice owner and a current dental practice broker. With over 27 years of ownership experience and a deep understanding of today’s transition market, Dr. Snydman explains what has changed—and what hasn’t—when comparing starting a dental practice from scratch versus purchasing an existing one. He shares the real challenges he faced during his 1996 startup, how he grew his operatories, and why finding a suitable practice to buy was far more difficult than expected.

Listeners gain insight into market shifts, risk tolerance, startup timelines, leasing considerations, and the rise of modern buyer expectations in today’s dental landscape.

Topics include:

●       Why a lack of viable acquisition options pushed him into a startup

●       What the startup process looked like 30 years ago vs. today

●       Overcoming hesitation, financing limitations, and buildout challenges

●       How strong retail co-tenants (grocery, banking, restaurants) impact patient flow

●       The role of PPOs, HMOs, and insurance strategy during early practice growth

●       How brokers evaluate practices and guide buyers in the modern market

●       Key lessons for today’s dentists choosing between acquisition and startup

Dr. Jesse Ritter shares his real-world journey of purchasing a dental practice in Towson, Maryland—including why he chose acquisition over a startup, how he evaluated opportunities, and what risk factors mattered most as a young dentist with student loans. He explains the importance of autonomy, owning your clinical decisions, and assessing the true stability of a seller’s patient base. Dr. Ritter also details how he negotiated purchasing the building, transitioned patients, and expanded his operatories over time.

New dentists considering ownership will find valuable insights into balancing risk tolerance, cash flow needs, real estate strategy, and patient retention during a practice transition.

Topics include:

●       Why acquisition felt less risky than a startup early in his career

●       How to evaluate a practice opportunity for cash flow and growth

●       Buying the real estate: when it makes sense and why it matters

●       Structuring seller transitions—and why continuity builds patient trust

●       Expanding operatories and modernizing a legacy practice

●       How associate experience shaped his decision to own

●       Key considerations for dentists relocating to a new market

Industry veteran Brian Frederick, with over 30 years in dental development, shares a high-level strategic view of when dentists should acquire a practice, when they should start one from scratch, and why the decision is rarely black-and-white. Brian explains how practice size, market demand, leasing strategy, and long-term growth planning shape the right path for each doctor. He also discusses why many new dentists undervalue build-outs, underestimate future expansion needs, and overlook the power of merging acquired practices into a well-designed startup.

This episode offers a realistic roadmap for doctors trying to choose between buying an existing practice with cash flow or building a modern, scalable space designed for long-term growth.

Topics include:

●       Acquisition vs. startup: key factors that make each option optimal

●       Why many older dental spaces limit growth and modern workflow

●       How lease length, square footage, and expansion potential influence success

●       Strategic advantages of merging an acquired patient base into a new startup

●       How DSOs changed the acquisition landscape—and what it means for solo owners

●       Hidden costs of retrofitting outdated dental offices

●       Why the “best practice owners” often start first, then acquire later

In this episode of How to Open a Dental Practice, banking expert Lori Riley breaks down the financial realities of acquiring a dental practice versus launching a startup. With 18 years of lending experience and deep expertise in dental acquisitions, Lori explains how banks evaluate risk, cash flow, borrower production history, practice profitability, and transition readiness. New dentists looking to buy their first practice will gain a clear understanding of what lenders look for—and how to avoid financing mistakes that can derail an acquisition.

Listeners will learn how practice valuation truly works, why two $1M practices can have completely different profitability, and how lenders determine whether a buyer has the production capacity to maintain or grow the business.

Topics include:

●       How banks evaluate dental practice acquisitions and lending risk

●       Why profitability—not collections—determines true practice value

●       Common financing challenges new dentists face

●       How lender conditions work (seller stay-on periods, production history, etc.)

●       Startup vs. acquisition lending: what banks see differently

●       What happens if a seller can’t complete their transition period

●       How to prepare financially before approaching a lender

In this episode, Arminco CEO Artin Safarian and Sara Reichenbach, Senior Consultant, speak with Dr. Madeleine Goodman of Harmony Pediatric Dentistry & Orthodontics in Bethesda. She is an orthodontist, entrepreneur, and the heart and soul behind Tiny Changes, a dental plastics recycling and sustainability initiative.

Dr. Goodman shares not only her passion for creating sustainable change in the dental industry but also her firsthand experience opening her own practice and navigating the challenges that come with practice ownership. Her work through Tiny Changes offers dentists a practical way to reduce the significant amount of single-use plastics generated in daily operations—keeping them out of landfills and moving the profession toward a more responsible future.

This episode is an excellent opportunity for dental professionals to learn how sustainability and practice success can go hand in hand.

To learn more about the process, visit Tiny Changes.
Interested in joining the initiative? Contact [email protected]
to receive a discounted recycling box and complimentary advisory services as a thank-you for your participation.

Arminco is the full-suite professional partner behind over 1,000 successful healthcare buildouts nationwide. We integrate strategy, design, and execution into one seamless process, delivering certainty where others deliver complexity. Arminco Inc. is a full-suite professional services partner helping healthcare professionals open and expand with confidence. With 20+ years, we deliver certainty through integrated, custom solutions, not cookie-cutter templates. From concept to care, our hands-on team turns complexity into clarity so you can focus on what matters most: your practice.

At Arminco, we believe great spaces start with great partnerships. For over 20 years, we've helped healthcare professionals across the country bring their vision to life with clarity, confidence, and certainty. As a vertically integrated professional services partner, we connect every phase of your project into one seamless experience. We don't hand off responsibilities. We take ownership from the first idea to your first patient, ensuring a custom, non-cookie-cutter solution built around your goals. With over 1,000 projects delivered nationwide, our proven process transforms complexity into confidence every time.

When contractor bids come back higher than expected, the issue often starts with what’s missing from the landlord’s work letter. In this episode, Art and Hailee break down a real situation where a healthcare tenant discovered major gaps in the landlord’s delivery—including no HVAC, no electrical panel, no drywall, and even no concrete slab.

For dental offices, these items can dramatically inflate construction costs and create unexpected budget stress.

This episode covers:
• Why bidding construction from design-only drawings leads to inaccurate pricing
• How missing core infrastructure can add $100K+ to your dental build-out
• What your landlord’s work letter must include before you sign a lease
• How to negotiate TI money when key elements aren’t delivered
• Why working with an experienced healthcare realtor matters

A must-listen for any dentist preparing to lease a new space and wanting to protect their construction budget.

Renovations can fall apart long before construction begins — and in this case study, a 3,500 sq. ft. dental expansion in Arizona shows exactly how. What looked like a “full” drawing set turned out to be missing critical engineering details, complete specifications, clear phasing, and even basic contract protections. The result? Four wildly different bids, unclear scope, and a project headed toward major cost overruns.
In this episode, Art and Hailee break down how vague drawings, incomplete contracts, and early contractor involvement can derail a renovation before it ever starts — and what every doctor should verify before signing anything.

Topics include:
• Why incomplete drawings lead to inconsistent bids and surprise costs
• How missing MEPs, open specs, and vague details create disputes
• The risk of starting a phased project without a defined shutdown plan
• What every dental contract must include (timelines, penalties, warranties, lien waivers, etc.)
• Why spending more on design and planning can save hundreds of thousands later

In this “Whoops, It Can Happen to You” episode, Art and Antonis break down a real-world situation that every dentist should understand before expanding their practice. A doctor attempted to renegotiate a sublease on an adjoining space—only to discover he was unintentionally renegotiating his entire lease without professional guidance.
Antonis walks through the hidden risks, overlooked opportunities, and the financial leverage most dentists don’t realize they have when adding square footage. From tenant improvement allowances to updating outdated floor plans, to protecting your future exit strategy, this episode outlines exactly what can go wrong—and how to prevent it by involving the right professionals before speaking to your landlord.

Many dentists assume that taking over a former medical office will save time and money — but as Art and Sara reveal, that’s often far from the truth. In this episode, they break down what really goes into converting a medical space into a functional dental practice. From occupancy codes and power upgrades to compressor rooms, plumbing, and fire-rated nitrous closets, every detail matters.

Tune in to learn:

Whether you’re eyeing a second-generation space or weighing your build-out options, this episode will help you make an informed, cost-effective decision.