Setting Up Your Mobile Practice: The Operational Framework Nobody Teaches in Dental School

"I want to be a mobile dentist, but I want to be a good one. The fact that I'm not already one troubles me." – Mitch Hedberg energy applied to practice setup

The Thing Nobody Tells You About Mobile Dentistry

It's not the dentistry that's hard. It's the logistics.

You spent four years learning how to prep a crown, but exactly zero hours learning how to negotiate a contract with a nursing home administrator who's juggling 47 other priorities.

Let's fix that.

The Legal Structure Decision (That'll Save You $50K in Taxes)

Before you buy your first piece of equipment, before you print business cards, before you do anything else—talk to a CPA who understands healthcare businesses.

Here's the framework:

Sole Proprietorship: The "I'm Keeping This Simple" Option

Pros:

• Easy to set up (basically just start doing it)
• Simple tax filing (Schedule C on personal return)
• Minimal paperwork

Cons:

• Unlimited personal liability (someone sues your practice, they get your house)
• No tax optimization strategies
• Can't bring on partners easily
• Banks hate lending to sole proprietors

Best for: Absolutely nobody. Next.

PLLC (Professional Limited Liability Company): The Goldilocks Zone

Pros:

• Personal asset protection (liability stops at the business)
• Pass-through taxation (avoids double taxation)
• Professional appearance (nursing homes trust you more)
• Can add partners/dentists later
• Can elect S-Corp taxation (massive tax savings)

Cons:

• Costs $500-2,000 to set up (depending on state)
• Annual fees and paperwork
• Requires separate bank account

Best for: 90% of mobile dentists

The Tax Optimization Play:

Once you're making $80K+ in profit, elect S-Corp taxation. Here's why:

Sole Proprietor making $120K profit:

• Self-employment tax (15.3%): $18,360
• Income tax: $20,000 (approximate)
• Total tax: $38,360

PLLC with S-Corp election making $120K profit:

• Reasonable salary: $70,000
• Self-employment tax on salary: $10,710
• Distribution (not subject to SE tax): $50,000
• Income tax: $18,000 (approximate)
• Total tax: $28,710

Tax savings: $9,650 annually

Over 20 years, that's $193,000. That's not rounding errors—that's a vacation home.

Professional Corporation (PC): The "I'm Going Big" Option

Best for: Multi-dentist operations planning to scale significantly

We'll cover scaling in Part 5. For now, PLLC with S-Corp election is your answer.

State Licensing and Regulations: The "Please Don't Make Me Read Legal Documents" Guide

Reality check: Mobile dentistry licensing is identical to traditional practice licensing in 48 states.

The two states that are different: California and Texas have specific mobile clinic registration requirements. If you're in these states, budget an extra $500-1,500 for registration and an extra 30-60 days for approval.

What you need:

1. Active dental license in your state (duh)
2. DEA registration (if prescribing controlled substances)
3. Business license (county/city level)
4. Professional liability insurance ($2,000-5,000 annually)
5. Commercial auto insurance (if you're transporting equipment in a vehicle)

Pro tip: Join your state dental association's mobile dentistry committee if one exists. They've already done the regulatory homework.

Insurance: The "I Hate This But It Matters" Section

Professional Liability (Malpractice)

Cost: $2,000-5,000/year for $1M/$3M coverage

Mobile-specific consideration: Some carriers charge more for mobile practices, claiming "increased risk." This is garbage—data shows mobile dentists have LOWER claim rates (more preventive care, less complex procedures).

Carriers that get mobile: TDIC, Dentist's Advantage, and MagMutual understand mobile practices.

General Liability

Cost: $800-1,500/year

Covers slip-and-fall, property damage, and other general business risks.

Equipment Insurance

Cost: $500-1,200/year

That $40,000 in equipment sitting in your vehicle? Protect it. Standard business insurance may not cover it adequately during transport.

Commercial Auto

Cost: $1,500-3,000/year

If you're using a vehicle primarily for business (transporting equipment to facilities), you need this. Your personal auto policy won't cover it.

Total insurance cost: $4,800-10,700 annually

The Contract Negotiation Framework (Or: How to Not Get Screwed)

Finding Your First Contract

Target facilities:

1. Nursing homes (200-300 beds = goldmine)
2. Assisted living facilities (smaller but consistent)
3. School districts (annual screenings + treatment)
4. Correctional facilities (federally mandated dental care)
5. Corporate wellness programs (emerging market)

How to find them:

Forget cold calling. That's amateur hour. Here's the professional approach:

Step 1: Research

• Medicare.gov/care-compare for nursing home locations
• State Department of Corrections website
• School district websites (find the health services director)

Step 2: The Introduction Email

Subject: Expanding Dental Access for [Facility Name] Residents

"Hi [Administrator Name],

I'm Dr. [Your Name], a licensed dentist in [State] specializing in mobile dental care. I noticed [Facility Name] serves [X] residents, many of whom likely have difficulty accessing traditional dental care.

I'd like to explore whether a mobile dental partnership could benefit your residents and simplify your healthcare coordination.

Would you have 15 minutes this week for a brief call?

Best regards, Dr. [Your Name]"

Why this works: You led with THEIR problem (resident access to care), not your solution (you need patients).

Step 3: The Discovery Call

Don't pitch. Ask questions:

• "How do residents currently access dental care?"
• "What challenges does that create for your staff?"
• "How many residents do you estimate need dental attention annually?"
• "What would an ideal dental partnership look like for you?"

Step 4: The Proposal

Based on their answers, craft a proposal. Here's the framework:

Sample Mobile Dental Services Proposal

Service Options:

Option 1: Monthly On-Site Clinic Days

• 1 day per month, treating 12-15 residents per day
• Comprehensive exams, cleanings, restorative work
• Cost: Billed directly to Medicare/Medicaid/Insurance
• Facility cost: $0 (we handle all billing)
• Benefit: Residents get care without transportation barriers

Option 2: Quarterly Screening + As-Needed Treatment

• Quarterly screenings for all residents
• Treatment scheduled within 2 weeks of diagnosis
• Cost: Billed to insurance, facility pays nothing
• Benefit: Proactive care reduces ER visits and pain complaints

Option 3: On-Call Partnership

• Residents referred to us as needed
• We come to facility for treatment within 48 hours
• Cost: Billed to insurance
• Benefit: No commitment, residents get care when needed

Start with Option 1 or 2. They provide consistent patient volume and predictable revenue.

Contract Must-Haves

Your contract should include:

1. Scope of Services: What procedures you'll provide on-site
2. Schedule: Specific days/times (give them predictability)
3. Space Requirements: Private room, sink access, electrical outlets
4. Facility Responsibilities: Scheduling patients, maintaining patient records, providing space
5. Billing: Clarify you bill insurance directly, facility pays nothing (usually)
6. Liability: Your malpractice covers clinical work, facility's general liability covers premises
7. Term: 1 year initially, with automatic renewal (protect your investment in relationship building)
8. Termination: 60-day notice (prevents them from dumping you without warning)

Red flags to avoid:

❌ Facility wants you to give them a cut of insurance reimbursements (legal nightmare) ❌ Facility wants exclusivity without guaranteed patient volume (you have no leverage) ❌ Facility won't provide written agreement (run away)

Scheduling Systems: The Difference Between Chaos and Cash Flow

Your scheduling complexity:

• Multiple locations on different days
• Varying patient volumes per location
• Equipment setup/breakdown time
• Travel time between facilities

Amateur hour: Google Calendar and hope Professional: Purpose-built scheduling system

Options:

Dentrix Ascend or Curve

• Cloud-based (access anywhere)
• Mobile-friendly
• Multi-location support
• Cost: $400-600/month

SimplyBook.me or Acuity (Modified for dental)

• Online booking capability (for referrals)
• Calendar sync
• Automated reminders
• Cost: $50-100/month
• Limitation: Not dental-specific, requires customization

Custom Google Sheets (Budget Option)

Create a master schedule with:

• Location (Column A)
• Day of week (Column B)
• Time blocks (Column C)
• Patient name (Column D)
• Procedure (Column E)
• Insurance (Column F)
• Notes (Column G)

Cost: Free Downside: No automated reminders, requires manual management

Dr. Huberman's Take on Systems:

Your prefrontal cortex has limited working memory capacity. Every time you have to remember which location you're at on Tuesday or manually send appointment reminders, you're using cognitive bandwidth that should be focused on clinical care.

Automate the mundane. Protect the precious.

The Equipment Transport Solution

You've got $40,000 in equipment. How do you move it?

Option 1: Cargo Van Conversion

Cost: $30,000-50,000 (used van + custom shelving)

Pros:

• Professional appearance
• Weather-protected equipment
• Can be branded
• Tax deductible

Cons:

• Upfront cost
• Ongoing maintenance
• Parking challenges at some facilities

Option 2: Trailer System

Cost: $5,000-15,000 (enclosed trailer + organization)

Pros:

• Lower upfront cost
• Can be pulled by personal vehicle
• Easy to detach when not working

Cons:

• Requires appropriate tow vehicle
• Backing up a trailer (some people struggle)
• Not as professional-looking

Option 3: Multiple Equipment Sets

Cost: $40,000+ (duplicate equipment)

Pros:

• Leave equipment at high-volume facilities
• Reduce transport time
• Professional appearance (permanent setup)

Cons:

• Requires facility buy-in
• Need secure storage at each location
• Higher upfront investment

Most dentists start with Option 2, graduate to Option 1 within 12-18 months.

The First 90 Days: Your Implementation Timeline

Days 1-30: Legal and Financial Foundation

• Week 1: Form PLLC, open business bank account
• Week 2: Get EIN, apply for licenses
• Week 3: Secure insurance (all types)
• Week 4: Set up accounting system (QuickBooks or similar)

Days 31-60: Equipment and Systems

• Week 5: Order primary equipment (8-12 week lead time on some items)
• Week 6: Set up scheduling system, create patient forms
• Week 7: Build marketing materials (website, brochures)
• Week 8: Start facility outreach (calls, emails)

Days 61-90: First Contracts and Launch

• Week 9: Discovery calls with interested facilities
• Week 10: Submit proposals, negotiate contracts
• Week 11: Equipment arrives, practice setup/breakdown
• Week 12: First patient treatment day

Reality check: Most dentists underestimate lead times. Order equipment BEFORE you have contracts. Equipment delays are the #1 reason mobile practices don't launch on time.

The Financial Model You Need to Build (Before Spending a Dollar)

Create a spreadsheet with three scenarios:

Conservative Scenario:

• 2 facility contracts
• 8 patients per day worked
• 15 days per month
• Average production per patient: $200
• Monthly production: $24,000
• Collections (80%): $19,200

Realistic Scenario:

• 4 facility contracts
• 12 patients per day
• 18 days per month
• Average production per patient: $275
• Monthly production: $59,400
• Collections (85%): $50,490

Optimistic Scenario:

• 6 facility contracts
• 15 patients per day
• 20 days per month
• Average production per patient: $350
• Monthly production: $105,000
• Collections (90%): $94,500

Your overhead should work at the Conservative level. If you can't be profitable treating 8 patients per day, your model is broken.

Our Witty Wisdom

"I used to worry about my business plan. I still worry about it, but I used to, too."

Planning is important. But executing despite imperfect plans? That's where practices are built.

The Mistakes We See Every New Mobile Dentist Make

1. Buying too much equipment too soon – Start with one complete setup, add second when patient volume demands it
2. Signing contracts without volume minimums – If a facility can't guarantee 8-10 patients per visit, it's not worth the transport time
3. Underpricing services – Your reimbursement should be IDENTICAL to traditional practices. Don't discount because you're mobile.
4. Neglecting patient experience – Just because you're in a nursing home doesn't mean clinical care should feel different
5. Not automating billing – Dental billing is complex. Hire a billing service ($500-1,000/month) or use a comprehensive practice management system

Your Week-One Checklist (Because Ambiguity Kills Momentum)

☐ Talk to CPA about PLLC formation

☐ Research professional liability insurance carriers

☐ Create list of 20 target facilities within 30-mile radius

 ☐ Calculate your break-even number (patients per month)

☐ Determine your equipment budget (realistic, not aspirational) ☐ Set up business bank account

 ☐ Create email templates for facility outreach

☐ Join state dental association mobile/public health committee

What's Next in This Series

Part 4: Patient Care Protocols in Non-Traditional Settings – How to maintain clinical excellence when treating patients in nursing homes, schools, and other environments. Infection control, documentation, and managing complex medical histories.

Part 5: Scaling and Exit Strategy – Building a practice that works without you, hiring associate dentists, and maximizing your exit valuation when it's time to sell.

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Ready to stop planning and start doing? DNTLworks has been equipping mobile dental practices since 1986. They've seen every launch scenario, every equipment configuration, every "I wish I had known that" moment. Learn from 38 years of experience at dntlworks.com

Discussion question: What's the scariest part of launching a mobile practice for you?