What Is Dental Real Estate Financing in a DSO Transaction?
In a DSO sale, the buyer often wants the practice — not the building.
Dental real estate financing in a DSO transaction refers to structuring conventional commercial real estate loans that allow a dentist to retain ownership of the practice building while leasing it to the DSO under aligned lease terms.
When the DSO Doesn’t Want the Building
In many DSO transactions, the buyer is clear: they want the practice—but not the real estate.
That leaves dentists facing common (and expensive) outcomes when the building is handled late:
- Selling the property under time pressure
- Accepting short-term financing that weakens long-term income
- Signing lease terms misaligned with cash flow
- Leaving equity trapped instead of repositioned
Handled early, the building becomes an asset that supports your transition instead of complicating it.
A Strategic Approach to Dental Real Estate in a DSO Transaction
Audrey and the T Bank Professional & Executive Lending team specialize in structuring dental real estate financing that aligns with DSO transactions and long-term income planning.
We help dentists:
Retain ownership of their dental building
Refinance through conventional commercial real estate (CRE) financing
Align loan terms with DSO lease structures
Unlock equity without rushed decisions
Create predictable income during work-back or retirement years
This is not a one-size-fits-all product. It’s a coordinated strategy that considers timing, lease structure, cash flow, and your long-term financial plan — in collaboration with your CPA, financial planner, and attorney.
Meet Audrey Wendel
Audrey Wendel is President of Professional & Executive Lending at T Bank and works with dentists nationwide on practice transitions and dental real estate financing aligned with DSO transactions.
She specializes in situations where a dentist is selling to a DSO while retaining ownership of the building — structuring conventional CRE financing that supports lease terms, projected cash flow, and long-term income planning.
She works closely with CPAs, financial planners, attorneys, and DSO buyers to ensure real estate decisions strengthen — rather than complicate — the transaction.
Who This Is For
This approach is built for owners and advisors who want the building handled as intentionally as the practice.
Dentists
You’re under LOI — or seriously considering one
You own the practice real estate
You want to retain the building and protect long-term income
You want clarity before closing pressure sets in
Advisors
You represent dentists navigating a DSO transaction
You need real estate financing aligned with tax, lease, and estate strategy
You value predictable execution and early coordination
What This Looks Like in Practice
Structured before LOI, real estate becomes a strategic asset — not a closing obstacle.
Structure financing in the real estate entity
This keeps the building separate from the practice sale — giving you flexibility on ownership, tax treatment, and long-term income planning.
Handled early, this expands your options.
Preserve long-term income potential
The building can remain a long-term income-producing asset — if structured correctly before closing.
The real estate should support the transition.
Align loan amortization with lease terms
Financing should reflect the lease you sign with the DSO. When the two are misaligned, cash flow and exit strategy suffer.
Structure and lease must work together.
Coordinate with buyer and advisors before closing
Real estate decisions made late in the process often reduce leverage. Early coordination protects flexibility and negotiating power.
Ideally addressed at LOI.
How Dental Real Estate Financing Works in a DSO Transaction
Retaining the building in a DSO transaction requires coordination — not improvisation. The process is structured, deliberate, and aligned with your broader transition plan.
Evaluate the Building
We review the property’s cash flow, existing debt, ownership structure, and your DSO timeline alongside your liquidity and long-term income goals.
This ensures real estate decisions support — not conflict with — the transaction.
Structure the Financing
Financing is structured within the real estate entity, with terms designed to align with the DSO lease, projected cash flow, and long-term planning considerations.
The goal is stability — not a short-term fix.
Coordinate with Your Advisory Team
We work closely with your CPA, financial planner, attorney, and the DSO to align financing terms, lease structure, and closing timelines.
Real estate should be coordinated — not addressed in isolation.
Close with Clarity
Frequently Asked Questions
No. Most DSOs prefer to lease rather than own the real estate. With the right structure, you can retain ownership and lease the building to the DSO — preserving long-term income and equity.
Not necessarily. While it’s ideal to evaluate the real estate at or before LOI, options often remain during due diligence. The earlier the conversation begins, the more flexibility you retain.
No. This is conventional commercial real estate financing structured to align with long-term lease terms — not short-term or bridge debt intended as a temporary fix.
In many cases, yes. Depending on equity, structure, and long-term planning goals, a refinance may allow you to unlock liquidity while retaining ownership of the property.
Typically, financing is made to the entity that owns the real estate (such as an LLC), often with a personal guarantee from the dentist. The final structure depends on ownership, tax strategy, and planning considerations.
Lease terms vary by platform but commonly include multi-year base terms, renewal options, rent escalations, and maintenance provisions. Financing should be structured to align with those lease terms to support stable long-term income.
The loan should be structured around lease length, rent schedule, and cash flow projections. When financing and lease terms are aligned, the building becomes a predictable income-producing asset.
Existing debt can often be refinanced, restructured, or incorporated into a new financing strategy. The appropriate approach depends on current terms, timing, and your long-term objectives.
Yes. Real estate decisions in a DSO transaction affect tax planning, estate strategy, and income planning. We work closely with your advisory team and the DSO to ensure alignment.
Ideally at or before LOI. Addressing the building early preserves more structuring options and reduces closing pressure.
The earlier this conversation begins—ideally at LOI—the more options remain available.
DSOs we currently partner with
Let’s Talk Before the Building Becomes a Closing Issue
Share a few details and Audrey will follow up personally or contact her directly:
Or contact directly:
Audrey Wendel
President, Professional & Executive Lending
[email protected]
972-689-2400
Name
Email
Phone
I am a: Dentist / CPA / Financial Planner / Attorney / Broker
DSO status: Exploring / Under LOI / In documentation / Closing scheduled
“What is your primary question about the building?”