Texas, Florida and Connecticut have seen the most DSO activity during the fourth quarter of 2025.
Becker’s compiled a list of more than 70 DSO affiliations, openings and acquisitions during the fourth quarter.
Here is how DSOs expanded in these states:
Texas: 11
Chicago-based Aspen Dental opened locations in Seguin, Nacogdoches, Palestine and Midlothian.
Henderson, Nev.-based PDS Health added Harpers Kids’ Dentistry and The Groves Dental Group.
Dallas-based Smile Doctors completed two expansion acquisitions with affiliated doctors: True Smile Orthodontics and Pendleton Orthodontics.
Dallas-based Apex Dental Partners expanded its network in Texas in November.
Choice Dental Group opened a location in Killeen.
Jenks, Okla.-based Lumio Dental purchased a dental practice in Southlake.
Source: 3 states with the most DSO activity in Q4 / Becker’s Dental