How do you scale a DSO without creating a collection of practices that operate like completely different businesses?

In this episode of The Real Talk of Dental, Brandi Marzolino sits down with Eric Pastan, who built a 45-practice DSO and sold it to private equity, to explore what sustainable growth actually requires.

Eric explains the difference between scaling and stacking, what private equity buyers value beyond EBITDA, and why repeatable systems, realistic projections, strong culture, and operational alignment make a dental group more valuable.

You’ll also hear why Eric walked away from his first attempted transaction, how to connect growth targets to actionable KPIs, and why the highest offer may not come from the right partner.

If you are growing a dental group or considering a future sale, this conversation will help you build a business that is easier to operate, more attractive to buyers, and strong enough to grow without losing its culture.

You’ll learn:

• The difference between scaling a DSO and stacking practices.
• What private equity buyers evaluate beyond EBITDA.
• Why Eric walked away from his first attempted DSO sale.
• How repeatable systems and accurate projections increase value.
• Why financial goals must connect to practice-level KPIs.
• How to evaluate technology before investing in it.
• Why the highest offer may not be the best offer.
• How to grow without sacrificing culture or operational control.

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We talk about:

00:00 What private equity is really buying

03:07 Eric’s journey building a 45-practice DSO

06:13 The state of DSO growth in 2026

08:30 Scaling versus stacking dental practices

12:03 How fast should a dental group grow?

15:10 Building systems that do not depend on the founder

20:08 How uncontrolled growth damages culture

23:03 Why Eric walked away from his first DSO sale

24:52 What made the organization valuable to buyers

28:43 The systems to strengthen before selling

35:07 Evaluating dental technology investments

38:04 Advice for DSO founders considering an exit

Connect with Eric

LinkedIn: https://www.linkedin.com/in/eric-pastan/

Website: https://www.elliottdavis.com/

Connect with me

LinkedIn: https://www.linkedin.com/in/brandimarzolino/

Instagram: https://www.instagram.com/brandi.marzolino/

https://courageandjoyatwork.com/

https://leadhershipexperience.com/

Phone: 616-682-6222

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